Hacker News new | past | comments | ask | show | jobs | submit login
NYC pilot tries mental health responders in place of police (bloomberg.com)
182 points by pseudolus on Nov 14, 2020 | hide | past | favorite | 187 comments



I work as an EMT for a 911 service. The general attitude that I have and other EMS providers I’ve talked with seem to share is that this won’t end well.

The first thing we’re taught is that the scene must be safe. If it’s not safe, we stage nearby until law enforcement or fire tell us to come in. The 911 dispatch is notorious for misevaluating the nature and severity of a situation, and generally we are toned out to an address and keep getting updates with call details as we are driving there. In this country where anyone can have a gun on them, there is no way in hell that I and my partner are approaching an emotionally disturbed person with no way to defend ourselves. If something goes wrong, the most effective weapon we have is an oxygen tank. And now the public’s perception of drugs like ketamine for chemical restraint is souring, so the message seems to be “Go deal with the worst our society has to offer, with no backup in case they try to hurt you, no not even safe chemical restraints. And no sorry we can’t pay you more than a cashier at WalMart... but you’re heroes!” Just last year a firefighter paramedic in my state was shot dead after administering naloxone to a man and saving his life.

Part of it is the compensation. Law enforcement officers are paid substantially more than the EMS folks here with the understanding that they take on more risk. We make $12 hourly... not enough to accept drastically increasing our chances of being hurt or killed.


You're an EMT. You aren't trained for this.

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

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

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

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

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


Apparently, they usually bring police with them, and they are often called to the scene by police. Adding a trained counselor for deescalation sounds nice, but it may simply be an enhancement not an alternative. https://www.streetroots.org/news/2019/05/03/portland-mental-...


It's both. Dispatch calls it out and sometimes police show up, sometimes they don't. The main thing is the team is focused on solving the problem vs controlling people while ignoring their problem.


If people are a danger to themselves or others, the cops should be there, period. Sorry if that hurts their feelings but once a situation triggers calling for assistance it’s not just about them anymore.


There are multiple problems with that simplified model of conflict engagement. The most immediate one is that it encourages people to call nobody and just try to sort out the situation themselves, because the risk of a simple call for assistance ending in the death of a loved one is too high right now.

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


What sort of training helps deal with violent and irrational people?


Simply not feeling you must deal with the situation right now.

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


> Simply not feeling you must deal with the situation right now.

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

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


https://www.youtube.com/watch?v=r1JXhSYfLNE

I'm only half joking.

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

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


> I'm sure the US economy won't be ruined by there being an extra $20 in circulation

In aggregate it would be.


No amount of "arrest random dude on the street with a potentially counterfeit $20" would address a systematic issue endangering the us economy.

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


I’m curious to understand why you think introducing a gun into this situation is going to make it any better?

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

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

Not sure where the downside is.


Just because there have been high profile cases which fit the narrative of what you already believe doesn't mean that that is an accurate picture of reality.

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

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

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

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

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


I guess my claim of "high chance that the individual will end up shot by the police" is hyperbolic.

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


not the 'official' answer here but if they're that far gone on drugs eventually something will happen where they'll either tire themselves out or lose consciousness.


Most UK civilians do not have guns either.

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

The US has 120 per 100 civilians.

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


Are you implying that enough people can't be trusted not to shoot at police with their guns that it justifies an armed response to every call everywhere in the entire country?


I think it’s more like if you are a first responder, the math tells you whomever you are dealing with has a gun. That changes the dynamic entirely.


The math doesn't say that - the 120 per 100 figure is misleading: obviously everyone doesn't own a gun. About 22% of people report owning a gun. So yes, a high figure, but the chance of someone owning a gun AND currently carrying it brings that number down a bit. I do agree that it's still quite a dangerous situation regardless.


1 in 5 is still far higher than UK first responders have to deal with.


Well then let's run the numbers: which math are you talking about, the number of guns? My question stands, then. After that, where is the line that changes the dynamic "entirely?"


I‘m not sure whether measuring the number of guns per citizen is a valid measure. Take a look at Switzerland.

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


You're ignoring cases (the majority I'd estimate based on 911 calls I've listened in) where others are affected.

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

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


Why begin with the assumption people are violent and irrational due to a random 911 call?

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

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

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

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


Listen to some 911 calls sometimes. People are often screaming, panicked, crying.


I have. Up until the recent protests dispatch here was in the open, so you could follow situations in real time. There's no reason that a taser, gun, or handcuffs help with the overwhelming majority of calls, including ones with someone who's panicked and crying.


Where can I find a representative sample of 911 calls?


The calls themselves aren't usually in the open due to privacy concerns, but you can listen to dispatch in many cities here: https://www.broadcastify.com


Exactly, which is why I'm highly skeptical of someone whose political position is justified by supposedly listening to 911 calls.

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


The one where you arent trained to just shoot people until they stop moving/gun runs out of bullets.


> which clearly has spread to you as well

How do you know this?


It is strange to see this opinion voiced by an EMT. There are millions of people in this country that grew up in a world without EMTs. If you were hurt or sick you had to get yourself to the hospital or rely on the police getting you there. Police obviously weren't able to properly handle these situations from either a training or equipment perspective. This resulted in countless people dying unnecessarily. That was seen as an obvious failure and eventually a job was created to bring medical attention to the scene of an emergency and remove police from the handling of these medical issues.

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

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

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


Sounds to me like you’re falling right into the stigmatizing myth that the mentally ill are especially likely to be violent. Even calling them “the worst society has to offer”, and so far nobody is calling you on it. Presumably there would be some up front report and assessment of whether the person is exhibiting violent behavior. The actual “worst of society” should obviously be dealt with by police.


It sounds to me like goodells is relating their experiences.

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

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


If the EMTs are being paid $12, is it any wonder dispatch is notorious for misevaluating situations?

Deep structural problems.


I don't follow. Why should EMTs getting ripped off be a factor in dispatch being unable to do more than relay whatever inaccurate or incomplete information they might gave been able to extract from a member of the general public over the phone? If a woman dials 911, says "Help!" then hangs up, how is the dispatcher supposed to accurately convey the situation to an EMT? EMTs should be paid more, but paying EMTs more won't address this problem.


Sorry, yes, I can see how my comment could be confusing.

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

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

Thank you.


I don't know what dispatch is paid, but EMTs are not dispatchers so this doesn't make much sense to me.


Paramedics have more training and are paid more. While $12 is pretty low it’s not the ceiling.


It's just as presumptuous that every mentally ill person is carrying a firearm and is violent.


It only takes one to kill you? I think that's op's point.


But it isn’t a good point absent the bad assumption that the mentally ill are more dangerous. It only takes one bicyclist that’s fallen off his bike to kill you. So what?


It isn't just the aspect of someone being mentally ill, it's someone being mentally ill and that their behaviour caused the police to be contacted.


like that one time a white woman called the cops on a black man in central park?

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


This is a symptom of people being to primed to believe that mentally ill people are dangerous, not a legitimate cause for concern.

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

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


Nobody in this discussion has presumed such a thing.


It's the explicit expressed fear in the root comment, and the basis of the police warrior ideology.


The root commenter has said explicitly of armed violent people: "the vast majority of patients are not like that"

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


Yet their claim is that we need to respond as though every mentally ill person is an imminent threat.


Their claim, as I've interpreted it, is that their lived experiences have lead them to believe any situation must be treated with caution because they never know what to expect. That is simply not the same as presuming that every mentally ill person is carrying a firearm and is violent.

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


But I think you've made my point for me:

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

This is

1. Exceedingly unlikely

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

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


And you're falling into the trap of "everything works in theory". Dont pretend the real world is a clear cut place. Boots on the ground experience breats armchair keyboard academics.


Spot on. In theory, it is a fantastic idea to send mental health professionals, without any guns or self defense tools, or any bodyguards (police) to an ambiguous high-intensity crisis situation that seems like it involves psychological distress. In reality, when those professionals come face-to-face with, for example, someone high off of bath salts or PCP, they might have to abandon the scene due to the imminent threat to their lives, which then results in both the drug user and random passerby being placed into harms way due to the government not sending a full complement of healthcare + police professionals to the scene.


It's too dangerous for anyone to go there. They should just launch missiles on any address 911 is called for.

There is always risk.


It sounds to me like you're saying mental illness is irrelevant when it comes to predicting a person committing harmful behavior, which is a bold claim to make, to say the least.


As a whole, people with mental health issues are more likely to be abused and harmed than those who don't. The rate of violence in those with mental health issues is the same as the general population.

Suicide rates are a separate issue.


There are a couple problems with those studies.

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

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

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

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

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


As someone with a family member with schizophrenia I can support this, things tend to turn violent during a psychotic event. Bed restraints in hospitals aren't just decorations.


> The rate of violence in those with mental health issues is the same as the general population.

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

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

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


> So among that group of mentally ill, what’s the violence rate compared to the “general population.” It’s going to necessarily be higher.

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

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

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

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


I would imagine someone whose behavior triggers a 911 call is much more likely to be violent than the average person, regardless of any mentally illness


I love it when someone with direct experience on the topic gets a talking to by someone without it.

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


You're an EMT. Which means you aren't trained to deal with mental health issues. Just like the police.


> You're an EMT. Which means you aren't trained to deal with mental health issues.

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


> We make $12 hourly... not enough to accept drastically increasing our chances of being hurt or killed.

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


Maybe, and with FDNY where this pilot is being tested I don't know how the pay compares, but it'd still be a big shift in how EMS is presented from the very beginning to trainees.

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

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


My thoughts exactly. Also, the success rate of calming down a mentally unstable person threatening violence to self or others is only about 33% for someone who is trained and knows the patient's history. That leaves a lot of risk for that other 67% of the time.


[citation needed]


The Tactical Edge p.349


Charles Remsberg. From 1986. One of the leading minds who got us into this situation.

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


What situation is that?

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


Why is this downvoted?


> In this country where anyone can have a gun on them, there is no way in hell that I and my partner are approaching an emotionally disturbed person with no way to defend ourselves.

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

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

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


In your view, what would be a good set of reforms?


Presumably they won't conscript mental health professionals into this work. It should be done on a voluntary basis. My understanding is that approaches like this work with acceptable levels of risk in other countries, so hopefully it will be likewise successful here. That being said, my gut reaction is that I would not want to be the person called upon to do this job, and I could understand any other person who felt likewise. I would want to be armed when dealing with people who are operating outside the ordinary human envelope of behavior. Maybe that's my Americanness talking.


Thank you for the risks and efforts you take and make every day.


If you make $12 an hour, you are not in NY state were the minimum wage is $15.

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

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

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


> Guns in NYC are fairly rare

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

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

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

> that crime rate is dropping lower and lower

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

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


I have also lived in Brooklyn my whole life. I have never seen a gun outside of a person's home or a gun store.

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

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

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

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


Are you a Stuyvesant kid?


What you are saying boggles my mind.

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

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


You can't go more than five minutes in NYC without seeing a gun on the streets.


Only because the police themselves are open-carry.


Right - people openly carrying guns every day on every street corner. It's madness, but people don't give it a second thought. Why do they need to be armed to the teeth like this? How did this become accepted by the public?


While I believe cops could suppress reporting of a wide variety of crimes, I find it a bit difficult to believe they could do much to suppress reporting of violent gun crimes. When people show up at hospitals with bullet holes, certainly that triggers the creation of a paper trail no matter how badly the cops want to ignore it.


> Guns in NYC are fairly rare

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


This is true, I was not counting police guns, which are in fact everywhere. I was not also counting military guns that started showing up after 9/11. I was only referring to civilian guns, which perhaps was not clear.


Are you a mental health professional? I would imagine that's a separate skillset, and one that would allow a person to better evaluate whether or not someone acting broadly "unwell" is likely to be dangerous.


Use of Ketamine is souring due to the death of Elijah McClain, so you should refrain from claiming it's safe. There is always risk when injecting someone with a chemical in an emergency or crisis situation. No doubt your job is tough and underpaid, but it sounds like your mindset is perfect to be complicit in acts of police brutality.


Ketamine is only used to prevent the use of more force or injury in scenarios where there is potential for higher levels of force or injury to be occur. It is a mitigating agent for higher levels of force.


Well, apart from in the Elijah McCain case; or do you mean that ketamine mitigates the willingness of the responders to use lethal force?


If someone doesn't get ketamine, the alternatives are:

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

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

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


....if there’s a real, imminent threat.

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

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


Sure, the indications for using it can be clarified. EMS would go for chemical restraint (i.e. ketamine) for someone where "excited delirium" is suspected. This doesn't mean literally anyone being ornery with the police - and generally we aren't even involved in those calls. A person in a normal state of mind won't break their arms or dislocate their shoulders when they're put in handcuffs. Someone who took too much meth very easily could.


In this case, it says they used 500 mg of ketamine in an injection, so basically they killed him with an excessive dose. Even though ketamine might have a higher LD50 you can't compare drugs without knowing the dose they are using.

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


500mg? Might as well just shoot (someone) in the head. Total unprofessionalism.

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


My protocols for excited delirium say ketamine 100-200mg IV/IO or 200-400mg IM.


That doesn't sound like a very safe protocol to follow considering the max dose in a controlled environment for depression treatment is 1mg/kg.


It's worth noting "excited delirium" is a controversial diagnosis.


True. Administering many drugs without the proper knowledge can be dangerous.


Well for Elijah McClain it was either given after police suffocated him or directly contributed to his cardiac arrest. He apparently was restrained when it was delivered. This does not seem to jive with what you're saying. Were they planning to extra kill him if the Ketamine wasn't there?


He can struggle while restrained, severely injuring himself, and even to the point of killing himself. Handcuffs are temporary restraints and a struggling individual can severely hurt themself or defeat them.

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

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


You probably shouldn't inject Ketamine into someone who has suffered cardiac arrest or brain death after being forcibly restrained. I am not sure how Ketamine is at all a hero here, or helped provide an alternative to save Elijah McClain from excessive force by the police. If anything it may have complicated his chances of resuscitation, or possibly further contributed to his death.

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

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


"You probably shouldn't inject Ketamine into someone who has suffered cardiac arrest or brain death after being forcibly restrained."

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

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

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

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


I think some of the confusion is people saying the hold killed him, but he appears to actually have regained consciousness after the hold, and was then given Ketamine, then shortly after the administration of Ketamine he went into cardiac arrest.

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

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

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

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

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

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

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


Vascular constriction can have latent effects, such as causing a stroke which results in brain damage or brain death. I haven't seen the duration for the two instances of cardiac arrest to know if they were long enough to cause brain death, especially if they were performing compressions, etc.

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

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


Is Ketamine advisable to inject into someone who has had deadly force used against them which could lead to stroke?

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

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

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

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

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


What explanation did he give? Why would they ask if someone has a condition as soon as they approach someone (and did he have even one)? Most people won't answer that because it's none of their business. The breathing complaints are common and with the right training (which it sounds like they didn't have), you are supposed to know which ones are legitimate.

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


He said he was an introvert and asked the officers to respect his boundaries. Do officers not know what an introvert is? Do they not know some people react poorly to bring touched? He also had asthma, which might be good to know before you decide to chokehold someone. There's tons of people in this world, who act differently to different stimulus, and mental healthcare in the US has historically been poor, so there are probably plenty of undiagnosed people walking around. Most people don't announce they're introverts during a police stop, this should have been a clue.

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

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


You clearly haven't been reading my comments.


From what I understand of ketamine, it would take several grams to kill a man while Elijah was given half a gram (which was evidently more than he should have been given, but should still have been well short of lethal.) It seems to me he was killed by the chokehold. If somebody fed you a pot brownie then kicked you in the face, would you say weed broke your nose?


Do you think the Ketamine helped his chances of survival? Even at therapeutic levels drugs can cause adverse effects. Why are EMTs injecting Ketamine into effectively dead people at the behest of the police?


Ketamine not helping is not the same as ketamine killing. If paramedics had instead applied bandaids, those bandaids would not have helped him, but that's no reason to claim he was killed by bandaids.

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


In this case though it actually looks like he was given an overdose when considering his body weight, and he suffered the cardiac arrest enroute to the hospital, not on site. Coroner suggests drug reaction, the hold or asthma attack might have all played a role in the death.

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


It sounds like this pilot is using a specific subset of workers who are being given some degree of specialized training to deal with these situations, and it sounds like you have not been given this training, is this accurate to the best of your knowledge?


We have some level of training at my level (EMT), and the paramedics I work with have more. But the stuff we're expected to cover is really broad - anything from a sexual assault victim and preserving evidence to your garden variety suicidal ideation. So given our role it's mainly geared towards identifying potential medical causes for their behavior. The best thing we can do for a patient is keep an open mind to why they're acting strangely. It could be an infection, stroke, overdose, withdrawal syndrome, postictal state after a seizure, tons of stuff.

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


Just wanted to say that I am absolutely astonished that "chemical restraint" with ketamine is a thing. I am confident it is not a thing where I am from (UK).

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


This is what "Defund the Police" means in practice and hopefully this could lead to meaningful and positive changes. I recently witnessed an encounter in NYC involving paramedics and police interrogating an individual who did not want medical care, and any involvement with police. The paramedic was definitely using deescalation skills that I would usually equate with police work, as the police took a stand back and see attitude. I didn't see the outcome, but it seemed there was no one size fits all solution for this particular situation and the skills needed by both professions had a large overlap.

The problem seems to be about eroding trust in the police relationship with communities. The solution being proposed is creating new trust relationship with another public organization. Either way we need trust with every public organization/community interaction in the end and moves like this, if successful, are still just solving half the problem.


A big step would be making police live where they work. There's a lot of talk about warriors coming in from outside to pacify an unruly populace.


Chicago, which has a long history of police abuse, has had residency requirement for police officers for years. What tends to happen is that officers live in one or two specific neighborhoods, far far away from the heavily policed neighborhoods. I believe it’s the same in St. Louis and other cities.

This is just to say that a residency requirement is not a panacea by any means.


HN has always seemed to me to be a community that is moved by data-driven approaches, and this topic has a pretty clear motivation to reduce police violence. As a result, I think some people may be interested in reading up on Comapign Zero's[1] 8Can'tWait initiative (https://8cantwait.org/), which has identified, tracked [2], and advocated for 8 policy implementations across municipalities in the U.S. which meaningfully reduce instances of police violence.

The policies include a Use of Force Continuum, Comprehensive Reporting requirements, De-escalation Requirements (which, here, in the context of mental health response is particularly valuable), and more. There are links at the bottom of their website which can help you dig more into their methods, if you're interested.

[1] https://www.joincampaignzero.org/

[2] https://useofforceproject.org/#review


Some of those proposals are good, others are terrible and totally unrealistic. In particular requiring law enforcement to always give a warning before using deadly force and ban shooting at moving vehicles will put them and the general public at greater risk. Sure police should issue a warning whenever possible but there are always going to be exceptional situations. For example terrorist attacks, mass shootings, and hostage situations.


Then they can claim an exception to the rule caused by exceptional circumstances. The overwhelming supermajority of police activity doesn't require dealing with terrorists (including active shooters and hostage situations).

Maybe SWAT can have slightly different rules regarding RoE, but those should be the exception.


That's the point. The #8CantWait proposal is problematic because it calls for strict bans without accounting for real world situations.

As for active shooter situations, guidelines now call for the first responding officer to immediately move in and attempt to stop the shooter by any means necessary. They aren't supposed to wait for a SWAT team to respond. It's ridiculous to propose separate use of force rules for them.


Like I said, exceptional circumstances can be exceptions to the rules. We can define a separate RoE for dealing with clear terrorists, but most cops will never engage with a terrorist.

It doesn't feel like you're trying to make a charitable interpretation of what everyone is asking for. You're welcome to suggest improvements to the language, but writing off the idea because of a "well actually" attitude smells of ideology.


Not at all. The problem is that the proposal is absolute and doesn't contain exceptions. It feels like you're intentionally missing the point due to ideology.


Sounds like this probably won't be a productive discussion then. Cheers.


Shooting into a moving car is insanely dangerous. The expected outcome is an uncontrolled moving car.


Sometimes that's a preferable outcome to the alternative. The North Hollywood shootout is an extreme example, but it illustrates the point; if bank robbers in a car are shooting at everybody they see, the cops shooting back at them is the only reasonable response.

This doesn't mean cops should be making a habit of having high speed shootouts on freeway; nobody wants that. It means the rules need to allow reasonable leeway for people to do what they think is appropriate in the unique situations they encounter. Blanket bans enacted by people reasoning about generalized scenarios are not a good idea. Those sort of absolute rules are too simplistic to be good for anything other than pandering to crowds.


There are some limited situations where an uncontrolled moving car is less dangerous then a controlled car being actively used as a weapon. For example, in the 2016 Nice truck attack if a police officer had a clear shot at the driver should they have avoided taking the shot?


Using a one time unique event as the reason for dismissing a provably valuable policy change isn’t very rational.

It would be like using a single child’s death caused by a vaccine as the reason to ban all vaccines.

Simply put, such a policy to save far more lives that it would cost, which must count for something. Or perhaps we should also stop using seatbelts and airbags.


There are certainly more examples beyond that one event. I support additional reasonable restrictions on police use of force but they have to allow for human judgment in unusual situations rather than flat bans.


Those proposing these restrictions see everything in shades of grey, to most of them it is self evident that officers would be able to exercise judgementand defend themselves after the fact by pointing at an exception. Those opposed tothe restrictions see everything as black and white, you do what the law says or you go to jail. I think... Generalizations are always always wrong.


Better than a controlled moving car aiming for pedestrians.


Did anyone else read this title as “NYC Pilot (that flies planes) Tries Mental Health Responders in Place of Police” instead of “NYC Tries Mental Health Responders in Place of Police”?


That's exactly how I read it and was envisioning a pilot calling mental health workers to get an unruly passenger off their plane.


Yes! I thought it was going to be a story about a pilot's first hand experience!


Literally read the headline 3 times before realizing it wasn’t related to an Airline pilot.


This was definitely a bit of a Foot Heads Arms Body moment.


Indeed.. maybe 'pilot program' would help.


Yes.


I think this is a great idea and aligns well with what the general public wants. However, I'm afraid it might lead to injuries or even deaths of health responders if the encounters turn violent due to mental illness, drug abuse, or general fear of authorities + concealed weapons. This would end up swinging public opinion right back to the other side again. Like most issues in America, this one is complicated.


Trying new ideas in low-risk ways is generally a good idea. Government is generally incentivized to keep the status-quo and not take many risks.

Your political position shouldn't affect your view of this effort, so long as it's novel, low risk and follows the data.


Low risk until a mental health professional gets shot.


Between 2003 and 2007, there were an average of 13 deaths of emergency medical workers in the line of duty. 57% were ground vehicular accidents and 31% were aircraft accidents.

https://www.jems.com/2011/10/31/studies-show-dangers-working....

89 law enforcement officers were killed in the line of duty in 2019, 48 as the results of "felonious acts."

https://www.fbi.gov/news/pressrel/press-releases/fbi-release...


"X bad thing could happen" is an bad argument because it can be applied to literally any scenario. I could choose not to go get groceries because it's a great idea, until I get hit by a car.


When making policies on serious (and dangerous) topics for a large population, a single death is not a large risk. Even if this policy is wildy succesful, I'd still expect people with mental illness, police, and mental health processions to be occasionally killed in interactions (as they are today).

The point is these are difficult situations and the goal would be to decrease the rate of bad outcomes, likely not eliminate them.


The net deaths might still be lower. 978 people have been shot by police in the US in the past year.

* https://www.washingtonpost.com/graphics/investigations/polic...


Wow, I wasn't aware of this data. 978 shot and killed in a year is way lower than I would have expected. Like, order of magnitude lower, possibly 2.


Exchanging a larger number of deaths of civilians for a smaller number of civil worker deaths is a good trade. Dead civil workers mean less people willing to do that work, which means less help available to people overall.


Out of how many police-citizen interactions? The raw number is meaningless without context.


I think your sentence is missing a "because" at the end. Why do you think that deaths are meaningless as an integer here but would be useful as a ratio? Usually I've heard this line by folks who want to minimize the perception of police killings.


Would you rather try it out on an entire state first? It is low risk compared to the alternative options to experiment.


Idea: disarm the police.

In practice, very few police interactions require a firearm, so why have that as the default? If a police officer is working in a dangerous neighborhood, then they can exercise their right to carry a personal firearm at their own expense. However, any decision to use the gun would be 100% the individual’s risk as they won’t be able to hide behind their departments policies and procedures as an excuse to shoot people. So a police officer deciding to shoot someone is no different from your neighbor deciding to shoot someone. It might also incentivize individuals to seek out real firearms training on their own.

EMS people might be trained in mental health, but police officers are better prepared to deal with aggressive people, defend themselves (with batons, pepper spray, tasers, etc), and make arrests.

For dangerous situations that require firearms, you can call in a completely separate organization dedicated to that, like SWAT or whatever.

Or is this too naive and/or stupid?


I think there's something to this idea. even in the most dangerous places in the US, the vast majority of criminals are not likely to shoot at police on purpose. cop killers almost always get caught and convicted (if they survive long enough to get to court), while in some cities the odds of getting away with killing a civilian free and clear are over 50%. certainly there are some enforcement roles where weapons aren't needed. for instance, if you need a gun to feel safe confronting a driver over a broken brake light, maybe it's just not worth pulling them over to begin with?

in general, I think there ought to be more parity between what cops are allowed to carry and do to defend themselves and what is available to civilians. if every patrol car needs an ar-15 in the trunk to safely traverse an area, shouldn't people who actually live there be allowed to at least carry a pistol? or alternatively, if it's not okay for a civilian to carry any sort of firearm, why should it be okay for police?


I generally agree with the bit about increasing parity. Some policies seem to relegate citizens to a lower class.

The part about the brake light doesn't sound like a good idea. Police do encounter people with more serious warrants while responding to minor infractions or calls. Some of these individuals are dangerous. It's best to have the equipment needed to deal with those situations. I think the shortfall is that some people lack the training to go with it.


> The part about the brake light doesn't sound like a good idea. Police do encounter people with more serious warrants while responding to minor infractions or calls. Some of these individuals are dangerous. It's best to have the equipment needed to deal with those situations. I think the shortfall is that some people lack the training to go with it.

are you saying police need to pull people over for minor infractions because a) this is a good way of catching people with serious warrants, or b) police need to pull over people for minor violations anyway and they need a gun in case the person turns out to be a violent criminal?

in the case of a), I think this is the kind of fishing expedition bs that makes it hard for people to trust the police. the idea that they are not just going to ticket you for the thing they actually saw you do, but also make the most of the opportunity to look for anything else you've done / are doing wrong seems needlessly antagonistic. I would also question how much more effective this is than compiling a list of the fugitive's vehicles, known associates' vehicles, stolen vehicles, etc. and just checking the license plate reader against it.

in the case of b), this is kinda my point. if there's a meaningful chance that the officer or the offender ends up dead in a traffic stop, this should probably increase the threshold for what kind of offense justifies a stop. a broken brake light isn't worth dying over for either party. just take a picture/video and send a ticket to the owner of the vehicle.

in the case of an officer responding to a call, they no longer have the initiative to decide whether an interaction needs to take place. in this case, I think it is much more justifiable for the officer to be armed.


The part you are missing in the B scenario is safety. Let's say one brake light is out. Now what happens if that person doesnt notice and the other one goes out? You could be looking at injury or death under the right circumstances. Then of course if you're saying that the offender is dangerous enough to attack a police officer,then surely they also pose a threat to the public. Getting those threats off the street is more of the A scenario perspective, but nobody said anything about fishing (there has to be reasonable suspicion).

There's always a chance that a person (including a cop) becomes violent. Do we just remove all laws? I don't think so. On a side note, there are plenty of laws which are already not enforced or not consistently applied and should be taken off the books.


so first off, and sorry for the pedantism, cars are required to have three brake lights in the US. if a single one is out, it should be replaced promptly, but it is by no means an urgent problem. anyways, I don't want to debate this specific example in depth. if you don't agree, I'm sure you can think of some other example of an offense that gives legal grounds for a traffic stop but doesn't really justify it. frankly I am of the opinion that a lot of low-level violations (traffic and otherwise) exist primarily as a means to circumvent the default protection against unreasonable search and seizure, but we may just have to agree to disagree on that one.

the thing that strikes me as particularly tragic about these police shootings is how many of them started as confrontations over fairly minor offenses. would it be so bad to just let a few more people get away with petty crimes? or better yet, can't we find a way to hold these people accountable that doesn't involve a face-to-face encounter with an armed officer?


Older models might have 2 lights. Some motorcycles might have only one.

"gives legal grounds for a traffic stop but doesn't really justify it."

What do you consider justification? According to the law and police regulations, it would be justified. Logic also supports the idea that if there is a law on the books, it should either be enforced or removed. In this case the law has the purpose (as almost all traffic laws do) of promoting safety.

"circumvent the default protection against unreasonable search and seizure"

How so? As I stated before, the law's purpose is to promote safety. Also, when you sign your registration card or driver's license, you are agreeing to obey the traffic laws. This isn't just some made up excuse to violate people's rights.

"can't we find a way to hold these people accountable that doesn't involve a face-to-face encounter with an armed officer?"

We already do this for some infractions like red light cameras (what a disaster) and speed cameras. It's possible this could be expanded further, but probably wouldn't be able to fit all driving laws or areas. Also, what's wrong with the officer being armed? This shouldn't have any negative impact on the stop and should be reasonable since there is a likelihood that the person could be armed too, which most of the time is not also not a problem.


This is the year 2020 - I'm sure we can do better than this. If the police see a problem with your vehicle, there should be a way for them to look up your license plate and send you a notice, rather than stopping you in a way that could put both you and themselves at risk.


We already do this for speed cameras and red light cameras (a disaster). The main problem with just sending a notice for other things would be providing proof of the infraction. And even then, there would still be situations where the the is a safety concern that would be better met by stopping the person (stuff like DUI for example).


> the vast majority of criminals are not likely to shoot at police on purpose.

And the vast majority of cops don’t shoot people either.


It's extremely naive and the fraternal order of police would never let it pass. I predict they'd all stand down rather than serving in such a ridiculous fashion.

First you should take into account that the US is not the UK (or another European nation where police officers don't carry guns). We have a serious gang and violent crime problem here. Cities like Chicago are battlefields, there are multiple murders every weekend. On holidays, you can casually see 100+ murders take place in two days.

Combine that with a big underclass population, wide availability of guns and drugs that induce and amplify psychotic behavior, intense racial hatred, hatred of the police, entire city blocks being infested with gangs, drugs and guns and do you really think disarming the police is going to solve anything? It's a recipe for disaster that's going to empower criminals and cause even more violence and death in the future.

You can't pretend -like most progressives- these problems don't exist just because you're well-off, living in your upscale, well-patrolled neighborhood. This is you living in a bubble. Most of the folks advocating for disarming the police, should go take a stroll in South Side Chicago or east St. Louis.


> disarm the police

> they can exercise their right to carry a personal firearm at their own expense

That's not disarming the police, just making them pay $500 out of pocket.


I guess "disarm the police department" would be more accurate


I think the issue with this is that you don't know ahead of time which situations will escalate dramatically and require a firearm. Plus, everyone knows police have firearms and so that alone may prevent escalation of a situation. I just don't think it's feasible in a country with so many guns.


Private citizens actually have a lower bar to prove a justified shooting in most places. Police are held to a higher standard already. In policy at least. Th practice of that policy may make it different.


A lot of people here rooting for their preexisting beliefs to be confirmed, rather than being happy that a city is experimenting and evaluating new ways of doing things.

NYC didn't dig in and defend the status quo. They also didn't flip over the table and change everything across the city because of a new idea that sounded nice. They're testing it.


I wish there were some service I could call in between 911 and... nothing. If I call 311 it almost always results in a call to 911, because they can’t do anything.

However, I worry about the safety of these mental health workers. I don’t know how they are going to do this safely.


Isn't the point of 911 that they dispatch the appropriate service? It seems like the real problem is that there aren't less-extreme responders, which this initiative is trying to fix. I want there to be only 911, and I want them to figure out who to send. People shouldn't be second guessing who to call, they should call the "I need help" number.

I could see where having something like a 311 might make sense, but it should just redirect to the same call center too. It'd help remove hesitation on calling.


The statistics are that most police officers never fire their weapon while on duty.

I think there's a small portion of scenarios where the presence of the weapon suppresses violence.


You can call the relevant agency directly. Similar to calling the police station for non-emergency calls instead of 911. Of course it depends on the specifics of any given scenario.


> You can call the relevant agency directly. Similar to calling the police station for non-emergency calls instead of 911.

that's not a meaningful distinction in a lot of places. 911 and the "non-emergency" number around here go to exactly the same pool of people. there's maybe just some small difference in the prioritization of the calls.

the only other published numbers are for administrative offices that are open 8-5, and rings the same desk you find yourself at if you walk into the lobby of the administrative building. they take lunch breaks, and there's usually just one person there working first-come first-serve.


Sure, it depends on where you are, who you are trying to contact, and how urgent the situation is. I'm just saying it can be an option. I've done this.


This sounds fine with a few caveats, less ill people dead. But unless there’s long-term supervision available for these folks, it is only a 72-hour band aid.

In our neighborhood they are back on the streets in a few days after getting naked in front of and screaming at girl scouts.


Cool, I hope this works out for the best.


I did my part: I read the article. I still have zero clue as to how evaluate whether any particular call will warrant this new or the previous, alternative approach.


"in place of police"

>The mental health responders will be accompanied by a police officer

uh oh


I am all for the pilot program so long as the politicians pushing for this are charged as accessories to any crimes committed against the people they are going to put at risk.

This is the very definition of insanity. In other words, ignoring reality and pretending that a fantasy in someone’s head is real.

My father in law is a retired cop. One of the most harrowing stories he tells is about when he and his partner entered this four unit apartment building. The kind where you open the front door and there are four doors along a short hallway.

The call was for yelling and screaming (a loud argument) from one of the units at 2:00 AM.

They opened the front door (unlocked) and stepped into the hallway to look for the apartment.

That’s when someone comes out of one of the apartments and immediately fires a gun towards them, emptying the entire clip.

His partner got shot twice. He was grazed once.

The guy ran off. Other cops arrested him later.

The vast majority of people are good. We don’t have cops to hand lollipops to kids playing at the park. We send armed cops into the worst possible situations and expect them to be buddhist philosophers. Sorry, that’s not the real world. Not when your job requires you to engage with multiple people a day, any one of whom could kill you.

Those of you who think you can philosophize with someone intent on killing you should take a weapons martial arts class to understand reality. Having done so myself for decades I can tell you I don’t want anyone with a knife any closer than 16 feet, maybe 20. Even someone relatively slow and without training can bridge a 20 foot gap and kill you with a knife before you know what happened.

People (and politicians) love to voice opinions about this stuff and yet none of them are willing to put their lives on the line as part of the experiment they propose. I’ll have respect for them when, armed with a candy bar and good intentions, they go face someone who could potentially kill them. We’ll see how long their plans survive contact with reality.


That sounds like a terrible situation. It's also completely anecdotal, and doesn't really contribute one way or the other to the validity of this pilot's approach. The point isn't that there are never any cases where armed police response is appropriate -- but rather that the vast majority of cases don't require one.

> The vast majority of people are good.

> We send armed cops into the worst possible situations

> your job requires you to engage with multiple people a day, any one of whom could kill you

These statements are exactly the point. The data shows that the vast majority of people involved in 911 calls are also not "the worst possible" people -- but police today are trained to consider every situation as if it were "the worst possible situation". And the data shows that this is not true in the vast majority of cases. No one is claiming that there is no risk, but rather that despite popular belief, the data indicates this risk is in fact not constant enough to justify armed, worst-possible-sitation response as the default. In addition, as your anecdote illustrates, in some cases even sending an armed police response isn't enough, and they get shot anyway. Programs like these can't solve for these edge cases -- what they do is recognize that these are edge cases, rather than the norm, which is the opposite of the approach taken by much of the police force today, and by your comment. Just as one piece of data from this very article:

> The NYC, Los Angeles, Denver and San Francisco test programs are all modeled after Eugene, Oregon’s Crisis Assistance Helping Out in The Streets (CAHOOTS) program, which has been in place since 1989. In 2019, it responded to 24,000 calls for service, less than 1% of which required an additional police response.

So no one is claiming that there is never any reason to call for armed response -- rather that it's only needed a very small percentage of the time. Can this program potentially completely eliminate any and all shootings, or terrible situations like the one you described? Of course not. But the data does indicate that in the vast majority of cases, armed response is more likely to make things worse, not better. Other cases definitely exist, but are the exception.


> The point isn't that there are never any cases where armed police response is appropriate -- but rather that the vast majority of cases don't require one.

The point is even simpler than that.

Let's say a cop deals with 10 contacts with random people for equally random causes every day. That's 200 contacts per month or, roughly, 2,500 per year.

Let's say only 1% of those encounters involve someone intent on doing harm to the officers, carrying a deadly weapon or willing to do anything at all not to get arrested.

That's 25 potentially deadly encounters per year. Imagine having a job where performing your job might get you killed 25 times per year. That's no joke.

And so that game, the gamble, the proposal, is to send out someone other than police officers to some cross section of calls. Fine. Good idea. The question is: How do we predict what side of that 1% each call will be on? In the case of my father in law, the call was like hundreds, if not thousands, of calls they had handled during their career. And yet, they came very close to being killed.

In other words, we are proposing to send ill-equipped people to a potential life or death situation nobody is able to predict.

That's where I come out on the side of: If you want to propose that (not you personally, a general "you", a politician, activist, whoever) then you better be willing to go out and take those calls before you send someone else out to do it. That, to me, is honorable. Anything else is fake virtue signaling while playing with someone else's life.

I think a leader must include this as one of his or her guiding principles: I will never ask you to do something I am not willing to do myself (or have not done myself). That goes from sweeping the floor to asking someone to walk into a potentially dangerous situation that could cost someone's life. It's easy to ask someone to clean vomit off the floor when you don't have to do it.


> we are proposing to send ill-equipped people to a potential life or death situation nobody is able to predict.

But no one is proposing that at all. The proposal is to send well-trained but unarmed people to these situations. You are the one who is claiming that by not having lethal weapons, they will be ill-equipped. This is an opinion that is generally not borne out by the data -- in the general case, guns don't make situations safer, they make them even more dangerous. The idea that the best and only way to handle every potentially dangerous situation is by involving lethal weapons is one that seems uniquely American. Most other countries in the world have drastically fewer guns, and drastically stricter restrictions on their use, both in the general population as well as in law enforcement, and have fewer rather than more gun deaths. For example, another comment in this thread mentions that in England, officers carry only non-lethal devices, and call in a SWAT equivalent in the rare cases where one is needed.

And all of this is ignoring the reason that this pilot is being run in the first place -- that we know that there is a huge problem in the United States with police officers shooting and killing people who were in fact not trying to kill them. By concentrating entirely on the potential safety of police officers, you are discounting the value of the lives of those who are killed by these officers because the officers are not, and probably cannot be (in the same way that police officers cannot generally be trained as EMTs), properly trained to handle acute but non-dangerous cases of mental illness. This pilot is a data-backed attempt to fight against the idea that it's always better to go in guns-blazing just on the off chance that someone may be actively trying to harm you, because that approach leads to a large amount of totally unnecessary civilian deaths. I'm also certain the well-trained unit of mental health first-responders understand the risks that they'd be taking, just like police officers do.

> you better be willing to go out and take those calls before you send someone else out to do it. That, to me, is honorable. Anything else is fake virtue signaling while playing with someone else's life.

> think a leader must include this as one of his or her guiding principles: I will never ask you to do something I am not willing to do myself (or have not done myself)

I'm genuinely curious how you imagine this "honorable" approach playing out in reality. Obviously, it's not possible for everyone to have done everything, so in the general case, we're talking about being "willing" to do something, rather than actually having done it (unless you would have ex-police officers legislate all laws related to the police, ex-firefighters legislate everything related to firefighting, ex-bartenders legislate anything related to bars, etc, which I hope you recognize is more than a little ridiculous given the variety of human experience and thus the size of the legislative body that would be required to follow this approach). Right now, you're applying this principle to responding to 911 calls. Would you then also require that everyone involved in any police-related legislation be appropriately trained to actually go and respond to these calls (as police officers are, and as the mental health responders would be)? Given police-related legislation is only one of many legislative topics, would you apply that same principle to legislation involving EMTs and firefighters -- only those who go through training to physically fight fires themselves or go out on ambulances should be able to propose and enact laws related to these activities? How could one possibly have the time to appropriately train in all potential professions? As for a more loose definition of "willing", I think you'd be hard-pressed to find a politician who would publicly say they weren't willing to (e.g.) fight fires, but I'm sure that's not what you actually mean.

I think this is a fallacy. You can think about, discuss, research, study, and enact programs, rules, and regulations about a certain area even without having first-hand experience in that area -- that is a basic principle of human society. You should certainly inform yourself (through aforementioned research and studies) of the knowledge that rests with those who do have first-hand experience, but given that we know that systemic issues and bias exist in pretty much any field, and that those who are closest to that field are most likely to be influenced by both these and personal anecdotal "evidence", I would steer clear from basing your decisions entirely on their opinions, rather than taking these opinions as part of a more holistic view.


I don't know if you live in the US or not. I'll assume you do for now. I certainly do. I have also lived in other countries. Context is very important when comparing nations.

Simple example: Earthquake in Japan, no looting at all. Same thing in the US and you are almost guaranteed to have all manner of debauchery and crime.

Like it or not, our culture is different from that of, say, the UK, Japan, Sweden or Ecuador. The comparisons are difficult at best. A number of years ago I was speaking to a retired cop from a Latin American country. He told me how they always gave violent suspects to state their case in front of the judge...if they could rise from the dead. Be careful to point at a place like the UK and assume that Bobby's with batons is going to work in the US.

> well-trained but unarmed people to these situations. You are the one who is claiming that by not having lethal weapons, they will be ill-equipped.

Maybe I didn't make it clear. They will end-up dead. Well-trained my behind. You cannot go up against a violent well-armed population with a degree in psychology. Every 911 call is a potential death sentence to a first responder. Every single one of them. Nobody can predict what they will encounter on arrival.

Are you old enough to remember when thugs were making fake 911 calls to actually ambush cops and kill them? Imagine that reality.

> You can think about, discuss, research, study, and enact programs, rules, and regulations about a certain area even without having first-hand experience in that area

Right. And then send someone else to die.

Look, the police force is reactionary. It reacts to what society exposes them to every single day. Here in the Los Angeles area, many years ago, there was a famous bank robbery where the crooks came out in full body armor while armed with firearms and (if I remember correctly) armor-piercing bullets. The cops had to run to a local gun shop to arm themselves and be able to protect the public from these maniacs.

While it is likely true that we need to reform aspects of policing, you are NOT going to achieve better results until we reform ourselves. That might means such things as real gun control and real societal reforms. It might means such things as truly caring about education and addressing the problems of communities where crime seems to be the only path out of poverty and despair for some.

Simple idea: If everyone is "happy" only deviants will resort to crime. You don't solve the problem by sending psychologists to 911 calls when you have a society that will happily burn down entire business districts in plain view of the world.

We have a problem, a real problem, and I am betting that policing is likely a minuscule part of it. Cops, despite what is promoted out there, don't go out every day with a mission to cause harm and mayhem.

Here's an exercise for you: Go to your local police station and ask to sit down and have a coffee with the captain. Tell him/her you want to understand their perspective on things. Then compare that to what is being proposed.

Aside from having law enforcement in our family, my old Aikido dojo was probably 75% law enforcement --a retired FBI guy runs it. As Mark Twain said: "A man holding a cat by the tail learns something he can learn in no other way". Very true.


That's awful... but by your own description, the police were no better as first responders in this particular situation.


I think the mistake you are making is one of interpretation. In did not share this personal anecdote to make a qualitative claim. Not at all. How could I?

Someone calls 911. Two people go to the address in question and somebody empties a clip into them before any contact takes place.

If anything the message is: Do not send unarmed people because they could die.

My perspective is admittedly simplistic: I have no problem with someone proposing to send folks without guns to try to deal with any random 911 call so long as it is THEIR skin in the game. It's easy to send others into potential life or death situation when there are not consequences whatsoever for the person making that decision.

As I said in my post, and I'll repeat here, taking a weapons martial arts class is quite humbling in that you quickly realize just how dangerous encounters with someone intent on doing harm could be.




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: