[Senate Hearing 113-885] [From the U.S. Government Publishing Office] S. Hrg. 113-885 LAW ENFORCEMENT RESPONSES TO DISABLED AMERICANS: PROMISING APPROACHES FOR PROTECTING PUBLIC SAFETY ======================================================================= HEARING before the SUBCOMMITTEE ON THE CONSTITUTION, CIVIL RIGHTS AND HUMAN RIGHTS of the COMMITTEE ON THE JUDICIARY UNITED STATES SENATE ONE HUNDRED THIRTEENTH CONGRESS SECOND SESSION ---------- APRIL 29, 2014 ---------- Serial No. J-113-57 ---------- Printed for the use of the Committee on the Judiciary [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] S. Hrg. 113-885 LAW ENFORCEMENT RESPONSES TO DISABLED AMERICANS: PROMISING APPROACHES FOR PROTECTING PUBLIC SAFETY ======================================================================= HEARING before the SUBCOMMITTEE ON THE CONSTITUTION, CIVIL RIGHTS AND HUMAN RIGHTS of the COMMITTEE ON THE JUDICIARY UNITED STATES SENATE ONE HUNDRED THIRTEENTH CONGRESS SECOND SESSION __________ APRIL 29, 2014 __________ Serial No. J-113-57 __________ Printed for the use of the Committee on the Judiciary [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] U.S. GOVERNMENT PUBLISHING OFFICE 28-397 PDF WASHINGTON : 2018 COMMITTEE ON THE JUDICIARY PATRICK J. LEAHY, Vermont, Chairman DIANNE FEINSTEIN, California CHUCK GRASSLEY, Iowa, Ranking CHUCK SCHUMER, New York Member DICK DURBIN, Illinois ORRIN G. HATCH, Utah SHELDON WHITEHOUSE, Rhode Island JEFF SESSIONS, Alabama AMY KLOBUCHAR, Minnesota LINDSEY GRAHAM, South Carolina AL FRANKEN, Minnesota JOHN CORNYN, Texas CHRISTOPHER A. COONS, Delaware MICHAEL S. LEE, Utah RICHARD BLUMENTHAL, Connecticut TED CRUZ, Texas MAZIE HIRONO, Hawaii JEFF FLAKE, Arizona Kristine Lucius, Chief Counsel and Staff Director Kolan Davis, Republican Chief Counsel and Staff Director ------ Subcommittee on the Constitution, Civil Rights and Human Rights DICK DURBIN, Illinois, Chairman AL FRANKEN, Minnesota TED CRUZ, Texas, Ranking Member CHRISTOPHER A. COONS, Delaware LINDSEY GRAHAM, South Carolina RICHARD BLUMENTHAL, Connecticut JOHN CORNYN, Texas MAZIE HIRONO, Hawaii ORRIN G. HATCH, Utah Joseph Zogby, Democratic Chief Counsel Scott Keller, Republican Chief Counsel C O N T E N T S ---------- APRIL 29, 2014, 10 A.M. STATEMENTS OF COMMITTEE MEMBERS Page Cruz, Hon. Ted, a U.S. Senator from the State of Texas........... 18 Durbin, Hon. Dick, a U.S. Senator from the State of Illinois..... 1 WITNESSES Witness List..................................................... 25 Earley, Pete, Author, Fairfax, Virginia.......................... 13 prepared statement........................................... 68 O'Donnell, Hon. Denise E., Director, Bureau of Justice Assistance, U.S. Department of Justice, Washington, DC......... 3 prepared statement........................................... 26 attachment................................................. 37 Paul, Aubrey Dale ``A.D.'', Jr., Sergeant, Plano Police Department, Plano, Texas....................................... 10 prepared statement........................................... 55 Quam, Hon. Jay M., Judge, Fourth Judicial District of Minnesota, Minneapolis, Minnesota......................................... 11 prepared statement........................................... 58 Saylor, Patti, RN, MS, Frederick, Maryland....................... 15 prepared statement........................................... 77 Wysinger, Alfonza, First Deputy Superintendent, Chicago Police Department, Chicago, Illinois.................................. 9 prepared statement........................................... 42 MISCELLANEOUS SUBMISSIONS FOR THE RECORD American Baptist Home Mission Societies (ABHMS), Valley Forge, Pennsylvania, statement........................................ 81 American Diabetes Association, Arlington, Virginia, statement.... 86 American Occupational Therapy Association (AOTA), Bethesda, Maryland, statement............................................ 91 Anchorage Coordinated Resources Project (ACRP), Anchorage, Alaska, statement.............................................. 94 Appleton Police Department Crisis Intervention Team (CIT), Appleton, Wisconsin, statement................................. 96 Arc of New Jersey, The, North Brunswick, New Jersey, statement... 439 Arc of the United States, The, Washington, DC, statement......... 428 Ashley, Lisa M., statement....................................... 251 Assistance to the Incarcerated Mentally Ill, statement--redacted. 99 Autism Services, Education, Resources, and Training Collaborative (ASERT), statement............................................. 98 Autism Society, Bethesda, Maryland, statement.................... 447 Autism Speaks, New York, New York, statement..................... 101 Autism Up, Rochester, New York, statement........................ 106 Bazelon Center for Mental Health Law, Washington, DC, statement.. 111 Bernard, Mary Ann, Bernard, BA, JD, Sacramento, California, statement...................................................... 275 Biasotti, Michael, Chief of Police, New Windsor, New York, and Author, statement.............................................. 302 Brown, Lydia, statement.......................................... 271 Brown, Marisa C., MSN, RN, Washington, DC, statement............. 273 Bruce, Robert ``Joe'', Caratunk, Maine, statement................ 205 Buckler, Ray D., statement....................................... 385 Cameron, Laurie, statement....................................... 246 Carr, Eileen, statement.......................................... 177 Cohen, Karen, Volunteer, National Alliance on Mental Illness (NAMI), and Open Our Hearts, statement......................... 348 Conrad, Sharon K., statement--redacted........................... 390 Corporation for Supportive Housing (CSH), New York, New York, statement...................................................... 149 Council for Exceptional Children (CEC), Arlington, Virginia, statement...................................................... 145 County of Maui Police Department Crisis Intervention Team, Wailuku, Hawaii, statement..................................... 289 Crisis Intervention Team (CIT) International, Inc., Memphis, Tennessee, statement and appendix.............................. 139 DeWitt, Candy, and Hans DeWitt, May 13, 2014, letter............. 127 Dwyer, Matthew, Parent and Community Advocate, Syracuse, New York, statement................................................ 288 Earley, Lois, statement.......................................... 256 Epilepsy Foundation of America, Landover, Maryland, statement.... 181 Estrada, Mike, statement......................................... 320 Family Resource, Information and Education Network for Down Syndrome (FRIENDS), Frederick County, Maryland, statement...... 192 Florida Crisis Intervention Team (CIT) Coalition, statement...... 189 Fraser, Steven, and Lourdes Fraser, Gaithersburg, Maryland, statement...................................................... 417 Freedom Center, The, Frederick, Maryland, statement.............. 451 Friedrich, Carla, statement...................................... 128 Gallagher, Susan, statement...................................... 419 Geesling, Deborah, Mesa, Arizona, statement...................... 162 Goodale, Bruce, and Pat Goodale, statement....................... 125 Goodale, Patricia, Saratoga Springs, New York, statement......... 383 Gustafson, Kurt D., First Assistant County Attorney, Chautauqua County Department of Law, Mayville, New York, statement........ 134 Hallmon, Kie'Iera V., Pikesville, Maryland, April 28, 2014, two letters........................................................ 236 Hindu American Foundation (HAF), Washington, DC, statement....... 199 IndependenceFirst, Milwaukee, Wisconsin, statement............... 202 Institute for Safety and Preparedness, Ltd., Port Washington, New York, statement................................................ 203 Jackson, Richard, statement...................................... 388 Jonathan Carey Foundation, The, Delmar, New York, statement and appendix....................................................... 209 Juvenile Justice Initiative of Illinois, Evanston, Illinois, statement...................................................... 234 Kanczuzewski, Sandra M., statement............................... 389 Keeling, Linda J., statement..................................... 250 Kelmar, Brian A., statement--redacted............................ 120 Kirkham, Charles, Lieutenant, Retired, Sunnyvale Department of Public Safety, Sunnyvale, California, statement................ 262 L.E.A.N. On Us, Shelby Township, Michigan, statement............. 238 Maryland Center for Developmental Disabilities (MCDD) and Ethan's Law Work Group, Baltimore, Maryland, statement................. 283 Maryland Disability Law Center (MDLC), Baltimore, Maryland, statement...................................................... 285 Mental Illness Policy Org., New York, New York, statement........ 292 Monterey County Behavioral Health Bureau, Salinas, California, statement...................................................... 321 National Alliance on Mental Illness (NAMI), Arlington, Virginia, statement...................................................... 326 National Alliance on Mental Illness (NAMI) Barrington Area, Buffalo Grove, Illinois, statement............................. 335 National Alliance on Mental Illness (NAMI) Chicago, Illinois, statement...................................................... 339 National Alliance on Mental Illness (NAMI) Illinois, Springfield, Illinois, statement............................................ 341 National Alliance on Mental Illness (NAMI) Minnesota, Saint Paul, Minnesota, statement........................................... 343 National Alliance on Mental Illness (NAMI) South Carolina, Columbia, South Carolina, statement............................ 345 National Alliance on Mental Illness (NAMI) Utah, West Valley City, Utah, statement.......................................... 346 National Alliance on Mental Illness (NAMI) Wake County, Raleigh, North Carolina, statement...................................... 349 National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD), Washington, DC, statement...................................................... 324 National Association of Police Organizations (NAPO), Alexandria, Virginia, statement............................................ 350 National Association of the Deaf (NAD), Silver Spring, Maryland, statement...................................................... 352 National Coalition for Mental Health Recovery (NCMHR), Washington, DC, statement...................................... 357 National Council for Behavioral Health, Washington, DC, statement 361 National Council on Disability (NCD), Washington, DC, statement.. 366 National Disability Rights Network (NDRN), Washington, DC, statement...................................................... 373 National Down Syndrome Congress (NDSC), Roswell, Georgia, statement...................................................... 376 National Down Syndrome Society (NDSS), New York, New York, statement...................................................... 378 No Health without Mental Health (NHMH), San Francisco, California, and Washington, DC, statement...................... 381 Palafox, Mary, RN, statement..................................... 277 Parker, Janet, D.V.M., statement................................. 169 Pitts, Donna, statement.......................................... 165 Rural Institute: Center for Excellence in Disability Education, Research, and Service, The, University of Montana, Missoula, Montana, statement............................................. 455 Southern Tier Independence Center, Binghamton, New York, statement...................................................... 405 Stanek, Hon. Rich, Sheriff, Hennepin County, Minnesota, statement 403 State of Maryland, Hon. Martin O'Malley, Governor, Annapolis, Maryland, statement............................................ 409 Strail, Carlton B., Syracuse, New York, statement................ 132 Sullivan, Michael, Michael Sullivan ADA Consulting, statement.... 312 Thompson, Sylvia, BA, CMC, daughter of someone with serious mental illness, and President, National Alliance on Mental Illness (NAMI) Westside Los Angeles, California, statement..... 421 University of Memphis Crisis Intervention Team (CIT) Center and Crisis Intervention Team (CIT) International, Memphis, Tennessee, statement........................................... 461 University of Nebraska Medical Center, Omaha, Nebraska, statement 466 Vera Institute of Justice, New York, New York, statement......... 471 Wall, Eileen, Systems Advocacy Team, Westchester Independent Living Center, statement....................................... 180 Washington State Criminal Justice Training Commission (WSCJTC), Burien, Washington, and Washington Cities Insurance Authority (WCIA), Tukwila, Washington, statement......................... 480 West, Bill, The Arc of Multnomah/Clackamas, Oregon, statement.... 118 Whalen, David V., Niagara University First Responder Disability Awareness Training, Lewiston, New York, statement.............. 152 Woody, Michael, Lieutenant, Retired, Akron Police Department, Akron, Ohio, statement......................................... 269 Wilsey, Mary, mother, statement in memory of Keith Vidal......... 279 Youngblood, Hon. Donny, Sheriff-Coroner, Kern County, California, and President, Major County Sheriffs' Association (MCSA), statement...................................................... 394 LAW ENFORCEMENT RESPONSES TO DISABLED AMERICANS: PROMISING APPROACHES FOR PROTECTING PUBLIC SAFETY ---------- TUESDAY, APRIL 29, 2014 United States Senate, Subcommittee on the Constitution, Civil Rights and Human Rights, Committee on the Judiciary, Washington, DC. The Subcommittee met, pursuant to notice, at 10 a.m., in Room SH-216, Hart Senate Office Building, Hon. Dick Durbin, Chairman of the Subcommittee, presiding. Present: Senators Durbin, Franken, and Cruz. OPENING STATEMENT OF HON. DICK DURBIN, A U.S. SENATOR FROM THE STATE OF ILLINOIS Chairman Durbin. Good morning, and welcome to this hearing of the Subcommittee on the Constitution, Civil Rights and Human Rights. Today's hearing is entitled, ``Law Enforcement Responses to Disabled Americans: Promising Approaches for Protecting Public Safety.'' In a moment, I will be making an opening statement, then recognize my colleague Senator Cruz, the Subcommittee's Ranking Member, for an opening statement as well, and I want to thank Senator Cruz and his staff for their cooperation. We have agreed on today's witness panels on a bipartisan basis. We are pleased to have a larger audience for today's hearing, demonstrating the importance of this issue. There was so much interest that we moved to a larger room. If anyone could not get a seat in this hearing room, we have an overflow room, 226 Dirksen. Let me also thank those following the hearing on Facebook and Twitter using the hashtag #Ethanshearing. This is in honor of the late Ethan Saylor whose picture is to my right and who we will hear about during the later testimony today. We are here to examine the growing role of law enforcement in responding to incidents involving persons with disabilities. State and local law enforcement have made great progress in combating violent crime and keeping communities safe. In recent years, law enforcement has been forced to shoulder a new challenge. Due to inadequate mental health and social services, police officers have many times become the first responders for disabled individuals in crisis. The deinstitutionalization movement has led to many disabled Americans' release from State and local institutions into the community and a large reduction of available inpatient beds. It is estimated the country has lost 90 percent of its public psychiatric beds since the deinstitutionalization movement began. The goal is certainly laudable. However, there has never been adequate funding to allow local service providers to care for the disabled Americans living in their communities, and in recent years, there have been draconian cuts in their meager budgets. As a result, police officers, sheriff's deputies, and troopers have been inundated with calls involving mentally ill persons, and with the reduction in inpatient bed space, our jails and prisons have become, sadly, our mental health institutions by default. This Subcommittee considered this issue in a 2009 hearing on mental illness in prison and jails, more recently in two hearings on the use of solitary confinement. An estimated 56.2 percent of the inmates in State prison--56.2 percent--have mental illness, 44.8 percent of inmates in Federal prison. Our focus today is the difficult challenge State and local law enforcement face in responding to incidents with individuals suffering from disabilities. This is a public safety issue. Numerous studies have found that at least half of the people shot and killed by police each year are mentally ill. And police officers are at risk as well. Many of us well remember the day in 1998 when a mentally ill man stormed the halls of this Capitol and fatally shot two Capitol Hill police officers who heroically confronted him and saved many lives in the process. This is also a civil rights issue. The Americans with Disabilities Act requires law enforcement agencies to make reasonable modifications to ensure that disabled Americans are not subjected to discriminatory treatment. And just this month, the Justice Department's Civil Rights Division found a local police department was required to implement certain remedial measures to protect the constitutional rights of disabled Americans. As is so often the case, local governments are leading the way in crafting innovation solutions. One promising approach we are going to hear about is the Crisis Intervention Team. It has two parts: First, training officers to recognize the signs of disabilities and to de-escalate a crisis incident involving a disabled person; Second, law enforcement building relationships with mental health and developmental disability communities. These relationships are critical to finding support and services for the disabled. Today there are more than 2,700 CIT programs in 48 States. Nationwide, localities with CIT programs are experiencing a noticeable decline in officer injuries, injuries to disabled citizens, and reduced detention rates. I am proud to say Illinois is one of the Nation's leaders in this area. Forty- nine counties in my State out of 102 have a CIT program, and we will hear today from the Chicago Police Department's CIT program, which is considered a national model. As local mental health and disability services become increasingly scarce, the burden on police officers is going to be even larger. It is incumbent on Congress and the executive branch to help local and State law enforcement shoulder this expanded role and develop practices that protect officers, disabled individuals, and the public. Now, I might say at the outset that we have a series of votes on the floor at 11 o'clock this morning, six in a row, and then the mandatory lunches follow of the Democratic and Republican Caucuses. So we have a hard stop of 11:15. So we are going to do our best to give everyone a chance to testify and entertain questions and then proceed from that point. Senator Cruz when he arrives will be given an opportunity for an opening statement when he does arrive. Our first witness I would like to welcome is Denise O'Donnell, Director of the Justice Department's Bureau of Justice Assistance. The BJA provides grants and policy development services to local, State, and tribal criminal justice programs. Prior to her tenure with the BJA, Director O'Donnell was Deputy Secretary for Public Safety in New York and Commissioner of the New York State Division of Criminal Justice Services, and before that, U.S. Attorney for the Western District of New York. Director O'Donnell, thank you for being here. We are going to give you 5 minutes for an opening statement, and your complete written statement will be made part of the record. In keeping with the practice of the Subcommittee, please stand and raise your right hand to be sworn. Do you swear or affirm that the testimony you are about to give is the truth, the whole truth, and nothing but the truth, so help you God? Ms. O'Donnell. I do. Chairman Durbin. Thank you. Let the record reflect that the witness has answered in the affirmative, and, Ms. O'Donnell, please proceed. STATEMENT OF HON. DENISE E. O'DONNELL, DIRECTOR, BUREAU OF JUSTICE ASSISTANCE, U.S. DEPARTMENT OF JUSTICE, WASHINGTON, DC Ms. O'Donnell. Chairman Durbin, Ranking Member Cruz, and distinguished Members of the Subcommittee, thank you for affording me an opportunity to speak to you today. As Senator Durbin noted, I am Denise O'Donnell. I am the Director of the Bureau of Justice Assistance within the Department's Office of Justice Programs. BJA's mission is to provide policy leadership, guidance, and support to State, local, and tribal partners in implementing evidence-based and promising programs to promote safer communities. I am pleased to speak to you today about the strong commitment of the Department, and BJA specifically, to law enforcement in their growing role as first responders to crisis incidents involving people with mental illness and developmental disabilities. It is important to begin by recognizing an often misleading perception that individuals with mental illness are violent. A person with a severe mental illness who has no history of substance abuse or violence has the same likelihood of being violent as any member of the general public. In fact, people with serious mental illnesses are estimated to be between 2.5 and nearly 12 times more likely to be victims rather than perpetrators of violence. Yet persons with serious mental illness make up a significantly disproportionate number of people in our Nation's jails. According to a 2009 report, of people booked into U.S. jails, 14.5 percent of men and 31 percent of women had a serious mental illness--rates in excess of 3 to 6 times those found in the general population. Law enforcement are often the first responders to mental health crises that occur in the community, and we are grateful for the work of the Senate Judiciary Committee and this Subcommittee in raising awareness around this issue. We are also very grateful for your support of the Mentally Ill Offender Treatment and Crime Reduction Act--MIOTCRA--which has enabled BJA to take a leadership role in addressing the intersection of criminal justice and mental health. Since 2006, this invaluable funding has enabled BJA to award 287 grants in 49 U.S. States, territories, and the District of Columbia. These grants support a broad range of activities, including Crisis Intervention Teams, mental health courts, treatment programs in prisons and jails, re-entry programs and cross-training of criminal justice and mental health professionals. To expand the reach of effective justice mental health programs, BJA has used grant funds to establish a National Law Enforcement/Mental Health Learning Site program in which six geographically diverse police departments who are leaders in this field mentor and host visits from other jurisdictions to improve their responses to persons with mental illness. The linchpin of BJA's efforts to build an effective law enforcement response nationwide has been through support of Crisis Intervention Teams, or CITs. CITs provide crisis intervention training to law enforcement and de-escalating situations involving persons with serious mental illness and a forum to partner with other organizations to coordinate diversion from jails to mental health services. There are currently over 2,800 CIT programs nationwide. Many have begun to offer training to corrections officers, dispatchers, firefighters, school resource officers, and specialized training for youth and for veterans. In many communities, CITs have served as a springboard for a broader collaboration between the criminal justice and mental health systems. I want to particularly recognize and thank Patti Saylor for participating in this hearing and for raising our awareness about the critical need for the justice system to develop sensitive and targeted responses to the special needs of individuals with intellectual or developmental disabilities. In 2013, BJA awarded funds to The Arc to create the National Center on Criminal Justice and Disability. This is the first national effort of its kind to address both victim and offender issues involving persons with disabilities. When fully developed, the National Center on Criminal Justice and Disability will serve as a national clearinghouse and online resource, as well as provide training and technical assistance in this important area. Other DOJ partners such as the Office of Victims of Crime and the Civil Rights Division are also very focused on the particular needs and vulnerabilities of developmentally disabled persons, and we believe the National Center will be an important resource for all of us. Mr. Chairman, Ranking Member Cruz, and Members of the Subcommittee, this concludes my testimony. I thank you for the opportunity to testify and would be glad to answer any questions that you have. [The prepared statement of Ms. O'Donnell appears as a submission for the record.] Chairman Durbin. Thank you for your testimony, and thank you for prefacing the testimony with the most important fact to be said over and over again: People suffering from these disabilities are no more likely to be violent than the population at large and more likely to be victims of violence, which is something we should stress over and over again. Today we are focusing on those instances where law enforcement is called into action, and I think it is worthy of a reminder on the record here that the men and women who put those badges on every single day literally put their lives on the line every single day for us. Any moment can be a life-or-death situation, and they are faced with that tension and that reality, and we should be cognizant of it and sensitive to it. So I guess two questions I would like to ask: What are we doing as a Government, at the Federal level and beyond, to make certain that they have the training to recognize the reality of these disabilities and how they are manifest? This is a challenge for many people with a great deal of experience in education to really perceive these things. And for those who are in law enforcement, faced with the tension of the moment, what are we doing to prepare them? Ms. O'Donnell. I agree, Senator, that it is so important that we provide training in this area, and that has been really a center focus of our efforts under the MIOTCRA-funded grant programs that we have, to fund programs that provide CIT training to look at the States that are providing leadership like Illinois to statewide take on the obligation to train law enforcement officers on these issues through CIT training, through more cross-disciplinary training with mental health professionals. So we are committed to doing this. The law enforcement community is large and diverse and presents a challenge to be able to reach out to law enforcement all across the country. But we see a real interest in this training and are committed to providing the training. Chairman Durbin. Just to put in a plug for another bill, I have introduced the Smarter Sentencing Act, supported by the administration, on a bipartisan basis in Congress, to reduce the rates of incarceration in the hopes that the money saved there can be directed toward more productive ways of keeping this a safer Nation, and this is certainly one of them, to upgrade the skills and equipment and training of the men and women in law enforcement by not wasting as much time and money with people incarcerated for periods of time way beyond what is necessary. There is another aspect of this which I find interesting in my State, and that is that we are starting to look at different court approaches. We have tried veterans courts, we have tried drug courts, and basically what we are saying is that certain criminal defendants should not be pushed right into the criminal justice system, but justice can be served, the safety of the community can be protected if we find alternatives for veterans, many times returning and struggling with substance abuse problems, with the stress and pressure of daily life, many times with PTSD. We have found that putting them in jail is not the answer. In fact, there are much better and more efficient ways to treat them in a humane fashion, and we are doing that across our State. The same thing is true when it comes to substance abuse. Rather than put the addict in jail with little or no treatment, we find ways to put them in programs that start to turn their lives around. Can the same be said when it comes to mental health courts? Are we at a point now where we should be looking at this from a different perspective? Ms. O'Donnell. Well, I agree with you, Senator. We are very fortunate at BJA that you have all entrusted us with the responsibility to provide leadership in the drug court and the veteran court and in the mental health court area. We support mental health courts through our MIOTCRA funding. We provide training, we provide mentoring courts through other mental health courts, for mental health courts, to be able to meet the high standards of our other problem-solving courts. But we think that this is an important area for the country as a whole. I personally have had a long-term relationship with Dr. Robert--or with Judge Robert Russell, who started the first veterans treatment court in my hometown, in Buffalo, New York. We have supported veterans courts now since they started in 2008. I think it is one of the most important things we can do as a Nation to pay the respect to our veterans who are returning from wars and are suffering from mental illness and PTSD to be able to provide a specialized court and work with the Veterans Administration to provide services to our veterans. Chairman Durbin. Before I hand it off to Senator Franken, I would urge, if possible, that your Division really focus more resources and more time, if you can, in the collection of data on law enforcement interaction with the disabled, particularly where force is used, so that we can understand this phenomenon and chart our progress, if we have some, in this area. So I hope you will consider that. Senator Franken. Senator Franken. Thank you, Mr. Chairman, for this important hearing. I have been working on a reauthorization of MIOTCRA and expansion of it called the Justice and Mental Health Collaboration Act, as you know. And in researching this and in living with this issue for a while, I have seen some amazing things and some great things, including--I am not sure where in this hearing I will tell some of the stories, but both police who use crisis intervention training in a way that is very moving and very productive, and the same in our prison system. I guess what I wanted to ask you about is sort of the cost- benefit analysis of this, because we have so many people languishing in our prisons who probably--well, who certainly are not benefiting by being there, and that we are not benefiting by being there. And what we have seen with the kind of programs that we are talking about is less recidivism, you know, all kinds of benefits from that. Can you talk a little bit about the cost-benefit of crisis intervention training, of mental health courts, and other initiatives? Ms. O'Donnell. Yes, Senator. First of all, we think it is huge. We have two projects that I want to just focus on for a minute. One is a project that the Council for State Governments is doing in New York City, in the Riker's Island facility, where they did probably one of the most comprehensive examinations of who is in that jail suffering from a severe mental illness and what is their length of stay. And they actually followed up on all of the records and determined that people with serious mental illness were staying in jail twice as long as other individuals in jail. That is a huge cost and certainly not contributing to their overall mental health. And so New York City is fashioning a response to that where they are really developing centers in each of their courts in each of the boroughs, looking at how they can intervene quickly, identify those individuals, and get them out of jail, and provide the kind of services that they need. And they will be following the cost-effectiveness of that approach. The second project that we have is under the Justice Reinvestment Initiative, which BJA supports, and it is a local JRI site in Texas. And that site is really doing a cost-benefit analysis looking at just 23 high users of the jails and the mental health and health services within that community, and taking those individuals from jail, putting them in supportive housing with wrap-around services, and projecting the cost savings from that approach. And I think that will help raise awareness of how we can manage individuals with mental illness in our jail system that are particularly nonviolent offenders in a much more cost-effective way in the community and with better outcomes for the individuals involved. Senator Franken. I have had a number of roundtables on this. One, our sheriff in Hennepin County, Rich Stanek, wrote an op-ed piece in the Star Tribune saying about a third of the people in his jails had mental illness and that is why they were there. And we have seen that putting people in prison with mental illness makes them sicker, costs us money. We have--I guess 25 percent of the prisoners in the world are in our prisons, and we have 5 percent of the population. And a great deal of those are people with mental illness who are not benefiting, who, if our jails are overcrowded and costing us money, we are actually having to release people in States like California. But these people could do much better if they go to a mental health court, and a mental health court usually means that the prosecutor agrees to this--right?--the judge, the arresting officer, everybody agrees that this is the best place for this person, and see if they can get treatment instead of going to prison. Ms. O'Donnell. Yes. Senator Franken. We are going to have another panel who will be talking about some of the tragedies that have happened because our police officers have not gotten the right training, the crisis intervention training that has been so beneficial and is such a big part of this. Thank you, and I guess we will move on to the next panel. I know we have some votes. Chairman Durbin. Ms. O'Donnell, thank you very much for your testimony. We appreciate it. We will ask that the second panel now come to the witness table, and while they are coming, I am going to read the introductions. I am going to save one introduction for Senator Franken, but I would like to introduce the others who are coming. Our first witness is Chicago Police Department First Deputy Superintendent Alfonza Wysinger. First Deputy Superintendent Wysinger is second in command of the Chicago Police Department, responsible for overseeing all its daily operations, served as an officer with the CPD for 28 years, many units, including patrol, narcotics, detectives, and the DEA task force, and we thank him for being here. In addition to that, we have Sergeant A.D. Paul, Jr., a veteran of the Air Force, an officer in Plano, Texas, in the police department, for the past 28 years; received the department's Officer of the Year Award, Supervisor of the Year Award, and Meritorious Service Award. He currently is an instructor with the Dallas Police Department's Crisis Intervention Team Program and a coordinator for the Plano PD's CIT program. I will let you introduce the next witness. Senator Franken. Okay. Well, it is my privilege to introduce the Honorable Judge Jay Quam of Minnesota. Judge Quam was appointed to the bench in 2006 following an 18-year career in civil litigation. He has served for more than 3 years as the presiding judge of his district's mental health court, and he has been actively involved in working with Minnesota's law enforcement community to improve collaboration between jails, courts, and mental health providers. Judge Quam offers valuable expertise and a unique perspective, which I have been the beneficiary of, and I am glad that he is able to join us today. Thank you for being here. Chairman Durbin. Thank you, Senator Franken. Our next witness is Pete Earley, a former journalist and author of 13 books. In his book ``Crazy,'' a Pulitzer Prize finalist, Mr. Earley wrote about his experience of trying to get his son out of the revolving door between hospitals and jails and getting the treatment that his son needed. He is a member of the National Alliance on Mental Illness and advocates for mental health reform. Our next witness is Patti Saylor. Ms. Saylor is the mother of Ethan Saylor, a young man with Down syndrome who was tragically killed in Frederick, Maryland, on January 12, 2013. Ms. Saylor, a registered nurse, is an advocate for people with disabilities, developmental and intellectual disabilities. She founded F.R.I.E.N.D.S., the Family Resource, Information & Education Network for Down Syndrome, a parent support network in Frederick, Maryland, and an affiliate of the National Down Syndrome Society, served on the Maryland Developmental Disabilities Council, co-founded The Parent's Place of Western Maryland. I would like to ask all the witnesses on the panel to please rise to be sworn in, as is the custom of the Committee. Do you solemnly swear that the testimony you are about to give is the truth, the whole truth, and nothing but the truth, so help you God? Mr. Wysinger. I do. Sergeant Paul. I do. Judge Quam. I do. Mr. Earley. I do. Ms. Saylor. I do. Chairman Durbin. Thank you. Let the record reflect that all the witnesses answered in the affirmative. Mr. Wysinger, I am going to put your written statement in the record and ask you if you would give us a summary. We would appreciate it very much. STATEMENT OF ALFONZA WYSINGER, FIRST DEPUTY SUPERINTENDENT, CHICAGO POLICE DEPARTMENT, CHICAGO, ILLINOIS Mr. Wysinger. Thank you. Good morning, Chairman and Ranking Member Franken. Police in Chicago, as in many other metropolitan cities, have been receiving an increasing number of calls for service to respond to situations involving individuals with mental illness and co-occurring mental health and substance abuse disorders. The Chicago Police Department responds to a minimum of 63 pre-identified mental health-related calls per day, over 23,000 per year. Such calls bring police in contact with the veterans impacted by post-traumatic stress disorder and/or traumatic brain injury who face their own unique challenges in seeking treatment services for support. Youth in desperately need de-escalation support and access to age-appropriate mental health and substance abuse services. All too often, these individuals lack the mental health care providers and non-treatment resources they need to lead healthy, law-abiding lives and to avoid becoming needlessly and inappropriately ensnared in the political and criminal justice systems. Thousands of calls for service are responded to annually by one of 1,800 Chicago patrol officers that have completed the 40-hour Chicago Police Department Crisis Intervention Training Program. These types of calls are responded to by officers who have not been CIT trained. If we are serious about jail diversion in crisis situations, law enforcement and mental health providers must work together to identify, analyze, understand, and solve gaps and weaknesses in the existing police-involved crisis intervention system. The Chicago Police Department and its award-winning CIT program and a network of strong mental health partners are uniquely qualified to do just that--improve the outcomes in Chicago and demonstrate strategies worth replication throughout the Nation. Therefore, it is critical that mental health treatment services that officers direct people to are responsive and effective. This can only happen if funding is available for these services to continue. We cannot arrest our way out of this problem, nor can we put all of our energy into CIT as the saving grace for this crisis. A broad range of services and psychological services must be accessible. Without these services or with inadequate services, officers--CIT trained or not--eventually will become disillusioned and may stop making efforts to link people to services. Without properly funding services and resources, the volume of calls involving persons with mental illness will only increase, which means that the needs of the citizens are not being met effectively or humanely, resulting in an increase of arrests of persons with mental illness and an increase in injuries to both officers and citizens. In Chicago, 50 percent of its community mental health centers closed in 2012, and one of three State facilities serving Chicago closed. That created a huge impact on public access, especially those with low income, to mental health services. While the closing of community mental health centers may play one role in the steadily increasing number of mental health-related calls for police service, it is not the only contributing factor. In Chicago, for instance, the overwhelming majority of people with serious mental illness brought to hospitals by CPD officers are of low income, uninsured, on Medicaid, and unable to obtain their own access to needed services. This unfortunately is the reality, and currently the three largest providers of mental health services are jails in L.A. County, New York, and Cook County Jail in Chicago. The Chicago Police Department recognizes that CIT programs are an effective tool. Data collected from federally funded sources of CIT Program found that, compared to their non-CIT- trained peers, CIT-trained Chicago police officers directed people to mental health services 18 percent more often. CIT- trained officers reported feeling better prepared to respond without needing to resort to the use of force and less force was used when the subject agitation increased. No one chooses to be mentally ill. In order for CPD CIT or any CIT program to be successful, it must maintain strong partnerships. The Chicago Police Department's CIT Program is more than just training; it is a partnership with mental health service providers, advocacy organizations, individuals, and family members living with a mental illness. Thank you. [The prepared statement of Mr. Wysinger appears as a submission for the record.] Chairman Durbin. Thank you very much. Sergeant Paul. STATEMENT OF AUBREY DALE ``A.D.'' PAUL, JR., SERGEANT, PLANO POLICE DEPARTMENT, PLANO, TEXAS Sergeant Paul. Thank you, Chairman Durbin, Ranking Member Cruz, and Members of the Committee for allowing me to testify here today. I am here to tel you about our CIT program. It is broken down into two major components: one is the training piece, and just as important is the collaboration or the partnership piece. I want to describe briefly the training. We have an initial 40-hour class in which all first responders will have to complete, and then we have subsequent training after that. That 40-hour class is broken into day one and two where the officers are trained on the mental illnesses, developmental delays, traumatic brain injuries. They also receive de-escalation communication and active listening skills. On days three and four, they have to go through reality- based training where they will answer a number of these calls involving anything from an Alzheimer's patient lost to a returning vet with PTSD. The officers must pass those scenarios to get to day five, and day five is probably the most exciting day of the training where we actually have consumers come in and interact with the officers. They tell about their encounters with law enforcement, and they also describe their road to recovery. I think it is on that day that you can actually see the stigma start to leave from the police officers. Many, like me, come to the job with just a basic understanding of mental illness, and what they get is from movies and TV and the news where they are often the villain in the script. The second part of our program is the collaboration or the partnership piece. It is vitally important. We have experts that come into the classroom and give the officers skills on how to recognize mental illness and developmental delays. They are also imperative when we work on a difficult or complex case. We cannot do it alone, and usually the best results come from the back end of those relationships when they get the support that they need. Also, the support from the advocacy and the provider community is tremendous. In law enforcement, we are going to make mistakes. And when we make those mistakes, it is imperative that those partners provide us with crisis. And if they know our hearts and our heads were in the right place, they will see us through those crises. The National Alliance on Mental Illness, or NAMI, has been a great supporter of CIT. They were in the beginning with the Memphis model, and they support local training today. Our local NAMI Collin County is a great resource. The only issue I have is when they bring donuts the training. I have gained a few pounds. CIT has been embraced by a number of law enforcement agencies. I think once administrators and sheriffs learn of the benefits, the empirical evidence, a lot of it gathered from the Memphis CIT Center at the University of Memphis, they will see the reduction in the number of injuries to officers, injuries to civilians. They will see the number of lawsuits and complaints on their department go down. So they are hungry for these programs. Unfortunately, only 2 percent of our local departments in our Nation have full CIT programs. About 15 years ago, I was involved in a deadly shooting involving the death of Michael Clement, a young man on the autism spectrum. Today I have a 12-year-old son, Christopher Paul, who is also on the autism spectrum. I believe that CIT programs can improve the lives of millions of Americans living with disabilities. Your efforts to help make awareness and funding for CIT programs across our Nation are imperative. Thank you very much. [The prepared statement of Sergeant Paul appears as a submission for the record.] Chairman Durbin. Thanks, Sergeant. Judge Quam. STATEMENT OF HON. JAY M. QUAM, JUDGE, FOURTH JUDICIAL DISTRICT OF MINNESOTA, MINNEAPOLIS, MINNESOTA Judge Quam. Thank you, Senator Durbin and Ranking Member Cruz and Senator Franken. As Senator Franken said, my name is Jay Quam, and I have been a Hennepin County District Court judge for a little more than 7\1/2\ years. During that time, I have seen the disproportionate number of people with mental health conditions come into all areas of the court system. But the area of the court system where they come in with the greatest number and with the greatest tragedy and heartbreak is in the criminal justice system. And what that means is that people with mental health conditions are too often brought to jail and then too often are left to languish there. You know the statistics. You talked about some of them. But when I am in court, they are not statistics to me. They are people like Kevin Earley, Peter's son; or Jason Moore, who was an All-America wrestler with a promising future before schizophrenia led him to break his neck by smashing his head on a jail toilet; or Michael Schuler, who stabbed his eyes out with a pencil. These are people to me, and they are people whose lives have been shattered by a disease they did not deserve, that they cannot control, and for which they are not able to receive adequate treatment. This is obviously a very complex problem that is deeply embedded in all of our communities. There is no simple, there is no easy, and there is certainly no inexpensive solution. But what I would suggest is that the Justice and Mental Health Collaboration Act is an excellent step in the right direction. And it is an excellent step in the right direction because it starts with the premise that the best way to keep people from languishing in jail is to keep them from being brought there in the first place. You already know about the CIT training. That initial point of contact can mean life or death. But it does not end there. The sad reality is that in most of our communities, when law enforcement encounters someone in mental health crisis, they have got three options: One is to leave them there, which is typically not really an option. A second is to bring them to the local emergency room, which, as you know, is an incredibly expensive option, but it very rarely leads to productive, successful outcomes. That leave the jail. And as you have heard and as you have seen, the jail cannot provide adequate mental health treatment for people with mental health conditions. The Justice and Mental Health Collaboration Act looks at a fourth option, and that option is a facility. I call it a ``mental health hub,'' ``crisis dropoff,'' ``central receiving center.'' Those are the terms that you use for a facility where someone who is in law enforcement who has encountered someone in crisis can bring someone and then get back on the street and do what they do best, and that is, keep our streets safe. That hub, as what I call it, has mental health professionals who can stabilize a person when necessary, assess them to figure out what condition is going on; provide appropriate treatment of them; and when it is safe and appropriate to do so, place them in the community so they do not have to go to jail, and then follow them with the resources that they need to stay there. It is a concept that has great viability and, in fact, in Minnesota, there is legislation that is putting together a working group that is tasked with proposing a mental health center. But it is not just successful in concept. There are some communities that have actually implemented this, including in Orange County, they have what is called a ``central receiving center,'' and it has been in existence for over 10 years. And in that 10-year period, they have gathered statistics, and they are amazing. They have served 47,000 people. They have saved over 100,000 jail bed days at a cost of somewhere of $20 million or more. They have saved 22,000 emergency room bed days, saving, depending on how you calculate it, somewhere between $17 and $44 million, all while allowing law enforcement a dropoff time of 12 minutes or less. So I would say mental health hubs should be a central part of any solution going forward. But, of course, some people are going to go to jail, and what you have already recognized, Senator Durbin, is that we need to be able to interact with those folks as soon as we can; and when we can safely and effectively divert them back to the community through mental health courts or veterans courts, we should do that. You have already expressed better than I can how effective they are, but what I can tell you is they are effective at giving people the lives that they deserve. So I urge you to continue to look not just at the initial point of contact but at every point through the process where you can work with people, find appropriate alternatives, and get them into the community so they can have happy, successful, and meaningful lives. Thank you. [The prepared statement of Judge Quam appears as a submission for the record.] Chairman Durbin. Thanks, Judge. Mr. Earley. STATEMENT OF PETE EARLEY, AUTHOR, FAIRFAX, VIRGINIA Mr. Earley. Thank you, Chairman Durbin and Ranking Member Cruz, for holding the hearing. Thank you, Senator Franken, for being here. ``How would you feel, Dad, if someone you loved killed himself?'' My college-age son asked me that question when we were racing from New York City, Manhattan, to Fairfax County, Virginia, where I live. My son, Kevin, had been diagnosed with a mental illness, bipolar disorder, a year earlier but he had stopped taking his pills. When I picked him up in New York, he had been wandering across that city for 5 days. He had barely slept. He had not eaten. He was convinced God had him on some secret mission. When we got to the emergency room, the nurse rolled her eyes because Kevin was talking about how God had him on his mission, and he said, ``Pills are poison.'' We were taken into a room. We were being separated from everyone else. We sat there for 4 hours. Finally, Kevin said, ``Nothing is wrong with me. I am leaving.'' I went outside. I literally grabbed a doctor. I will never forget how he came in that room. He came in with his hands up as if he were surrendering. He said, ``I am sorry, Mr. Earley. I cannot help your son.'' I said, ``You have not even questioned him, investigated, asked him anything.'' It did not matter. Virginia law was very clear at the time. Unless you were in imminent danger, you could not be forced into any treatment. You could not be required to take any pills. And my son had said he thought pills were poison. The fact we had been sitting there for 4 hours meant there was no danger. So I was told, ``Bring your son back after he tries to kill you or kill someone else.'' I took my son home. Forty-eight hours later, I saw him sink deeper and deeper into a mental abyss. He slipped out of my house. He slipped out early, broke into a stranger's house. Luckily no one was there. It took five police officers to get him out, and an attack dog. He was charged with two felonies: breaking and entering, and destruction of property. I was so frustrated. Virginia law had kept me from getting him help when he needed it, now wanted to punish him for a crime he committed when he was not thinking clearly. I am a journalist. I decided to investigate this. I discovered this is not an aberration. As has been said before, right now as we are sitting here, there are 365,000 people with schizophrenia, major depression, and bipolar disorder in our jails and prisons. In 44 States, there are more people in jails and prisons than there are in State mental hospitals. I spent 10 months in the Miami-Dade County jail following people through to see what happened to them if they had mental illness. Who are these prisoners? They are people like my son. They were not Hannibal Lecter serial killers. They were crowded into cells built for two prisoners. Beatings by guards were common. It was barbaric. My son got 2 years of probation. He did great. As soon as his 2 years ended, he quit taking his medication. I could see he was slipping. I called the Fairfax County Crisis Response Team. They said, ``Is he dangerous?'' I said, ``No.'' ``Call us when he is dangerous.'' The night he became violent, I called them. They said, ``Oh, he is violent? We do not come if he is violent. Call the police.'' The police came. They shot my son twice with a taser and hog-tied him and took him away and said, ``Do you want to file charges?'' I was so outraged. The last time my son had a mental breakdown was a holiday. He was afraid I would call the police. He jumped in his car, he took off. He ran out of gas in North Carolina. He called me. He could not get out of that car because he was hearing voices that said if he got out, he would die. I arranged for him to get gas. He drove, psychotic, up 95. He got home. We went to a safe house. He said, ``I do not want to take pills. Just take me somewhere safe.'' He got up in the middle of the night. He took off all of his clothes because he thought that made him invisible. But listen to what happened to him this time. This time, a CIT-trained police officer picked him up, and my son said, ``Please do not handcuff me.'' The officer said, ``I can use my discretion.'' He treated him with respect. He took him to the hospital, and I was told that when the doctor said, ``Well, he is not really dangerous,'' the CIT officer said--and I do not recommend this--``Well, maybe I will take him to your front yard and let him loose.'' At that point my son was admitted. He got a case manager, Cynthia Anderson, who is sitting down here in the cowboy boots next to my son, Kevin. She said to him, ``Why don't you take your meds?'' She got him with a doctor who actually talked to my son. They found a medication that actually helped him, a low dose. She said, ``Why don't you live with somebody besides your father?'' She got him into housing with two people with schizophrenia. She said, ``What do you want to do with your life?'' He said, ``Well, I have a mental illness. What can I do?'' She said, ``Do not say that. Control the illness. Do not let it control you.'' He became a peer-to-peer specialist, a person with mental illness who actually goes and helps other people with mental illness. He is part of our Fairfax Jail Diversion team right now. In fact, he holds two jobs. He works on weekends at a movie theater as an assistant manager. He lives in his own apartment, pays taxes, and has not had a relapse in 6 years. My son is an example of what can happen when a person with a severe mental illness is given the tools that he needs to recover. Crisis Intervention Training literally saved his life. Jail diversion, mental health courts, re-entry programs, all of these help persons avoid costly and unnecessary jail and prison sentences. But we need more. We need social workers like Cynthia Anderson to get him supportive housing, meaningful treatment, jobs, and, most importantly, give them hope. As a board member of the Corporation for Supportive Housing, I have seen hundreds of Kevins recover when they simply just get a safe place to live. There should be no shame in having a mental illness. There should only be shame in us not helping them. And, sadly, our Nation has much to be ashamed about. Thank you. [The prepared statement of Mr. Earley appears as a submission for the record.] Chairman Durbin. Ms. Saylor. STATEMENT OF PATTI SAYLOR, FREDERICK, MARYLAND Ms. Saylor. Thank you, Chairman Durbin and Ranking Member Cruz and Senator Franken. Thank you for being here to listen. I am really excited that this Committee is interested in this subject matter that is so dear to my heart. I have a bit of a different story. As Ethan's mother--Ethan was not mentally ill. Ethan was born with Down syndrome, which is a completely different issue. He had limited cognitive ability. I want to tell you that I am here as a grieving mother. It has been 14 months. I am not sure that it will ever stop. My family is here, Ethan's cousins, aunts, uncles. We are all still grieving very much for our Ethan. I want to tell you a little bit about him if you have never met someone with Down syndrome before. Of course, everyone with Down syndrome is their individual person. No two people are alike, just as we are not alike. But Ethan was the most loving, compassionate person on the planet. No one ever met Ethan that did not walk away with a smile. He had his challenges. He was frustrated a lot in life. Most of his challenges came from the world not understanding him, not valuing him, wanting things that other people had that he could not have--a wife, a college education, a driver's license. So he dealt with a lot of frustration. He had quite a few passions in life. We have over 500 pictures on my computer right now that people have sent and I have looked at, and I have looked at everything from his lifetime. And his passions become very clear when you look at it. Law enforcement was one of his passions. Ethan has an entire collection of law enforcement badges and hats and memorabilia that law enforcement officers would give to him. Law enforcement was never called to respond to Ethan. Ethan called law enforcement on a daily basis because he wanted a job, he wanted to know if they had a dog, he wanted to see their gun, and mostly he just wanted to be friends with the law enforcement officer. As he got older, that expanded to CSI, FBI, NCIS, Secret Service, and we have a million stories which we like to sit around talking about Ethan's stories because they bring us so much joy in our life. We live in Frederick County, which is obviously where Camp David is. I worked as a camp nurse across the way at a camp for kids with special needs. And my family was there. Ethan, of course, being independent and strong-willed and lacking total judgment, decides he is going to go visit the President, the sitting President at the time, and I tried to explain to him that that would not be a good idea, that he could get hurt if he did that. Well, he disappeared and kind of wandered away, and I knew right where he had gone. So, luckily, the Park Service brought him back. But when I had a conversation with Ethan, I said, ``Honey, they are not going to know that it is you.'' He said, ``But, Mommy, I am a good guy. I am a good guy. It is okay. I will not hurt the President.'' And that is what he thought. He did not realize what would happen to him or how people would perceive him. On January 12, 2013, Ethan went to the movie theater. He went to the movies in our town all the time. He had supports. He benefited from a Medicaid waiver. He had private insurance, lots of family, lots of community support, and he had Government benefits as well. So he had a lot of support, and his support staff was with him, his support staff that was loving, kind, loved him, and he loved her. He had a great say in who he hired. When he did not pay for the second ticket when he went back into the theater, the theater manager called security. Security were three off-duty sheriff's deputies. They went into the theater after his aide had told them that he had Down syndrome, that I was 5 minutes from the theater, I would help him transition to coming home, or help him stay, and that she could get him out if he needed to leave. They disregarded her and told her to stay out of the viewing area. They went in. The one officer approached him, nicely at first, but demanded that he leave. Ethan was trying to buy a ticket using his cell phone. He had no money. He did not drive for himself. He needed to depend on others to get the things he wanted in life, and he wanted to stay and watch the movie. The officers proceeded to physically remove him from the theater, dragged him from his seat, tried to handcuff him. When that did not work while he was standing, they placed him on the ground, prone restraint, put handcuffs on, and my son died of asphyxiation on that floor of that movie theater for that $10 movie ticket. Ethan was not escalated. He was not threatening. He was not in crisis. He had a problem that needed solving. How do I stay and watch the movie when my aide is telling me it is time to go home? I would have solved that problem in literally absolutely 5 minutes. Since then, we have done a lot of advocacy in Maryland. We are talking about training. The Governor of Maryland has written an executive order that established a commission to look at law enforcement policy, and we are really looking to change things in the State of Maryland, and you could be extremely helpful in the Federal level. [The prepared statement of Ms. Saylor appears as a submission for the record.] Chairman Durbin. Thank you very much, Ms. Saylor. The testimony from this panel has been so touching, and I am sure all the Senators feel moved by what you have had to tell us. Mr. Wysinger, when you take a look at 1,100 or 1,800--I have forgotten the exact number--of the officers in the Chicago Police Department who have CIT training, it really raises a question about those that do not, those who are not new recruits and do not go through the 40-hour course. Do you have any estimate of what it would cost your police department, our police department, to give training to all of those who come in contact with the public? Mr. Wysinger. No, Mr. Chair, I do not have an overall cost of what it would cost to train everyone. But in addition to the new officers, we do send some officers back for refresher courses. The new recruits coming through get 4 hours of training, and we also send officers that have taken the basic training to our advanced 40-hour course. So I would probably have to get back with you with a monetary answer to that, and that I will do, sir. Chairman Durbin. I wish you would. [The information referred to appears as a submission for the record.] Chairman Durbin. Sergeant Paul, what a great testimony you gave us. You implemented a program where your police officers in Plano go to the homes of children with developmental disabilities and interact with the kids so that they can establish a comfort level between the police officers and those with disabilities. Can you explain this program and how you happened to bring it to Plano? Sergeant Paul. Yes, sir. We know that a lot of this population have a fight-or-flight response to police officers, just their presence and the uniform, the badge, the gun, the police car. So we thought that we had a program where we could be proactive, meet the child or even young adult at their place, communicate in the means in which they communicate, that we are here to help. One of the issues in the autism world is wandering, and a lot of times we are looking for the child in our police cars with our PA systems, and we have got experience where the child stayed hunkered down. So we were looking for not only the fight-or-flight response when we make contact with them, but also to allow us to find them when they go wandering. So it was just an effort on our part to bring a program, to be proactive so that that population will have more comfort with uniformed officers. Yes, sir. Chairman Durbin. Thank you. Mr. Earley, when you observed the Miami-Dade criminal justice system, you concluded that 97 chronically mentally ill people in that community accounted for 2,200 arrests, 27,000 days in jail, 13,000 days in crisis units, at a cost to the city of $13 million over 5 years, demonstrating that an uncommonly small number of chronically mentally ill people were consuming a large amount of law enforcement resources. What approaches have you seen that address this issue of repeat--if others who are not speaking would turn off their mics, maybe that will help. Thank you. What approaches have you seen that successfully address the problem of repeat mentally ill offenders? Mr. Earley. Thank you, Senator Durbin. Wrap-around services, intensive services, assertive community treatment, where the treatment team goes to the person who has a mental illness, instead of handing someone who has a mental illness, who probably does not even have a watch, if they are one of the hard-core homeless persons who are on the street, and telling, ``Go here for this appointment,'' and ``Go here for this appointment,'' they actually go in. That along with housing first are essential. The key is CIT, getting an intervention, then getting those persons into the right program that can actually help them. I am glad you brought up the Miami jail. A hundred thousand dollars a day they are spending there. For one-third that, you could provide housing first, which takes a person whether they have addiction or mental illness and says, ``We are going to give you a roof first. Then we will deal with your addiction,'' and an ACT team, someone who can come in and say, ``This is how we are going to help you. Why don't you take medication? Have you thought about jobs?'' Those are the most successful. Chairman Durbin. Ms. Saylor, one of the parts of the tragedy involving your son is a different aspect than what we have talked about so far. Admittedly, the three security officers that you referred to at the movie theater had some capacity in another part of their lives in law enforcement, but they were private security guards in this circumstance here. What have you learned about their training before in their law enforcement capacity and whether they had any exposure to counseling or training in dealing with mentally ill people? And what can you say about those who are in the private sector security world? Ms. Saylor. The three officers were sheriff county deputies working as security guards for the mall, and they had a short training in mental illness. But to our knowledge, they had no training in interacting with someone with an intellectual disability or a developmental disability such as Down syndrome. So we are not aware of any training that they had had. Chairman Durbin. That is an important distinction and one which I had not thought about and should, and I am glad that you brought that up as part of it. Senator Cruz. OPENING STATEMENT OF HON. TED CRUZ, A U.S. SENATOR FROM THE STATE OF TEXAS Senator Cruz. Thank you, Mr. Chairman, and I want to thank each of the members of the panel for being here and for sharing your testimony. In particular, Ms. Saylor, I want to thank you for sharing what I know is a heartbreaking experience as a mother, and let me say I am sorry for your loss. Mental illness and mental disability are challenges we face in our society and face far too many. It has been reported about 6 percent of the population or 1 in 17 Americans suffer from a serious mental illness. About 200,000 of the mentally ill right now are homeless. About 125,000 are incarcerated in jails. And our resources to deal with that challenge are diminishing, and so I appreciate each of you highlighting the problem, highlighting the need for more attention to care for those with mental illness, to provide treatment, and to help those who are able to live to the maximum degree with independence and self-respect and dignity. In my family, my grandmother suffered from Alzheimer's, and for over a decade we saw her faculties diminish to the point where they were altogether gone. So I have seen firsthand in my family how challenging it can be to deal with a person who no longer has the capacity to interact in a way to take care of herself, and that was a very challenging thing for my family. I wanted to ask, Ms. Saylor, having gone through what you went through, looking forward what do you think law enforcement can do and should do to prevent future tragedies like the tragedy that happening to your son? Ms. Saylor. Well, I have thought of that a lot, and I think two things. I think, first of all, we need to build the capacity in the communities for relationship between law enforcement and people with intellectual and developmental disabilities. If we have a relationship, we are less likely to hurt each other, and there would be a greater understanding that a person with Down syndrome that may be refusing to get up out of their seat is really not questioning the officer's authority. Two different issues. So I think that we need to look at activities to build capacity relationship. Second, obviously law enforcement needs to have training. But with that training, it needs to be dispelling some myths and assumptions, because there was an assumption that my son might be violent or harmful. It did not exist. That was not the issue. So getting rid of some assumptions and stereotypes along then with the training, like Senator Paul has talked about--I mean, Senator Paul? Officer Paul. Senator Cruz. Perhaps one day Sergeant Paul will join us as Senator Paul. [Laughter.] Sergeant Paul. Thank you very much. Senator Cruz. Well, and let me take that opportunity to shift to Sergeant Paul. First of all, I just want to thank you for your years of service as a police officer in the great State of Texas. Sergeant Paul. Thank you. Senator Cruz. Before you became an instructor with the Dallas Police Department's Crisis Intervention Team and coordinator for the Plano Police Department's Crisis Intervention Team, what sort of training or protocols were given to police officers when interacting with an individual with mental disabilities or mental illness? Sergeant Paul. Throughout my career, we have had different pieces of active listening skills, verbal judo, these sort of things, and they kind of skirted the disability community and substance abuse. I think one of the issues is from day one of the police academy, and rightfully so, officers have to be trained to control their environment. They have to use escalation of force to control their environment. That is what keeps them safe. And they are taught that throughout the whole academy and then in field training. The issue comes, some of those same techniques that we are trained in the academy can aggravate someone in crisis. And so communications I think is one of the keys to this for our department. If we can communicate with our community, that we have CIT officers, that we do have the training, if you can get that information to us as quickly as you call in to the 911 dispatch or if the public suspects that there is mental illness, while that officer is still going to control his environment, he can shift into that CIT mode a lot quicker and start using some of those skills, giving some control back to the person so that we can start that de-escalation of that situation and then they can resolve the situation. Senator Cruz. Right now what percentage of officers would you say have some significant CIT training? Sergeant Paul. With about 2,800 police departments in our Nation with CIT programs--and you are talking about usually major police departments--that would seem like a high number. I think the issue, though, with 14,000 local police departments, we are missing a lot of those officers, a lot of those agencies. In our department, we decided to train all of our first responders, our school resource officers, our hostage negotiators, our neighborhood police officers; anyone who might be the first responder on a scene of an incident, they are going to be required to go through the 40-hour training. I will get back with you on the number of officers. Senator Cruz. Mr. Wysinger, do you have anything to add from the perspective of Chicago on that same question? Mr. Wysinger. I would have to agree with Sergeant Paul's analogy. I think the more officers that we actually have trained and able to respond to situations makes for a better environment for public safety. We have implemented a process in Chicago where our dispatchers are actually trained, so they know which officers have gone through the CIT training and they can actually screen some of the calls to ensure that if a call is warranted of a CIT officer, the officer is immediately dispatched to try to help de-escalate the situation before it even rises to a level of use of force. So using that CIT training, being able to dispatch them to the scene first actually goes a long way with ensuring that the public is safe. Senator Cruz. Thank you very much. Chairman Durbin. Senator Franken. Senator Franken. I want to thank all the witnesses for being here today, especially Mr. Earley and Ms. Saylor. I know that the experiences you related are very difficult, especially for you, Ms. Saylor, and very difficult but a good outcome for Mr. Earley, which is inspiring. And I know your stories will help a lot of people know that they are not alone and hopefully will enable Congress to make the reforms that we need, including more crisis intervention training. Thank you for what you do, Sergeant Paul. You know, I will just try to tell this as fast as possible. I went to the Columbia Heights Police Department, and it is a suburb in the Twin Cities, and they had had CIT training. And I asked, first of all, give me some idea of what the effect had been, and the sheriff was not there, but the county attorney was, and he apologized for the sheriff not being there. He had to do something. And he said, well, the day after he got the CIT training, he did not kill a guy he would have killed. So I just turned to a police officer, a woman police officer, and said, ``Could I get a more garden variety example?'' You know, and she said, ``Okay, garden variety.'' She was a policewoman. She said, ``Garden variety. Okay. I do not know. About 3, 4 months ago I was out on the street, and I heard a woman screaming, and I thought it was some domestic violence thing. But she was just screaming, and then she went to this railing on a wall leading down to a playground, and I recognized what was going on, kind of.'' And she said, ``By the way, CIT training is something I use every day. I will probably holster my gun once in my career, but it is something I use every day.'' And she said, ``I was able to talk this woman, if she had dropped''--she had threatened to drop, to let go, and if she had done that, she would have gotten--I do not know if she would have gotten killed. She would have gotten very badly hurt. She talked her off. She said that she had been sexually abused as a child and that the abuser was back in her--had come back. He had left and had come back in her life. And then she said, ``I told her, `I think I can get you some help.' '' She referred her to the community mental health services. She said, ``About 2 months later, I was working a community fair. A woman came up to me and said, `Thank you. You saved my life.' '' And I said, ``Okay, that is the garden variety story.'' That is the garden variety story. So thank you for--I really do believe that we need to have CIT training for every law enforcement official. I think it should be in the Justice and Mental Health Collaboration Act, which, thank you, Sergeant Paul, for endorsing and thank you all, Mr. Quam, for endorsing today in your testimonies. It would do that. It would give that in academies and other training for officers. I have also heard from corrections officers what a difference it makes in, you know, the--I was in St. Cloud State Prison where they were talking about the different--I remember one officer saying, one of the corrections officers saying to me, ``You know those things on TV on the weekend where they show these guys have to suit up because somebody is out of control, and they put on masks and they put on gear and go in there. Sometimes all you have to do is talk to the person, and it saves a lot of wear and tear.'' But let us talk about after the crisis intervention training. Judge Quam, you run a mental health court, and what is the difference--what does that do in terms of outcomes, in terms of outcomes for them and for us, for everyone? What is the outcome of having that and hopefully veterans courts, et cetera? Judge Quam. Thank you, Senator Franken. There are two different mental health courts: one is a commitment court where there is civil commitment; the other is what more people know, and that is the--we call them ``problem-solving mental health courts.'' And the statistics nationwide, not just in Hennepin County, are phenomenal for the effectiveness of courts like mental health court and veterans courts. And they work because they provide what Mr. Earley suggested they need, and that is the services that someone needs in order to survive and thrive out in the community. That is one component. The other component that makes it effective is intensive judicial supervision. So there are a lot of check-ins, there is a lot of monitoring, and there is always the threat of incarceration if the person is not following the path that they need. When you combine those two components, the statistics are amazing. I cannot spout one off right now, but an incredibly high percent of veterans, people with mental illness, people with drug issues or dependencies can avoid reincarceration, have jobs, become the types of people that they had the potential to become before they became involved in a mental health or problem-solving court. Senator Franken. My time is up, and I know we have votes, but the costs-benefits in terms of not just actual dollars to the taxpayer but in terms of the lives, this is a more issue, too. Mr. Chairman, can I ask Mr. Earley to speak to that? Chairman Durbin. Sure. Senator Franken. Or Judge, anyone on the panel, and then I am done. Mr. Earley. Well, I went into jail, and I saw people who could have been my son, so it was very personal to me. And I also read the statistics, and one of the statistics you were after, 85 percent recidivism rate for persons with serious mental illness in jails and prisons--85 percent; 80-percent recovery rate for those same people if you give them--go through a mental health court, get into treatment, have wrap- around services. The point that Senator Durbin was making earlier about the cost-benefit should be right on. We are spending that money. Senator Cruz talked about a lack of resources. We are already spending it. We are spending $30,000--in Miami, $35,000 a year to keep those frequent flyers going back and forth. We are not getting anything for it. Why not use that money for something that works? Senator Franken. Thank you all--or, Judge Quam? Judge Quam. If we have time, I have just got a short story that brought the humane point to me. I was presiding over a commitment case once, and I saw from the file it was a guy about my age. He came into court. It was a guy who looked maybe 80 years old, 75 years old, had schizophrenia beginning somewhere when he was in his 20s, spent most of his life on the streets or in jail or in homeless shelters. He could not talk very well. It was a very short hearing because of that. But he wanted to tell me something, and I told him, ``Once we are done here, your lawyer will talk to you, make sure he knows what you said, and he will come and tell me.'' So a couple minutes later, the lawyer came in and said, ``This does not make any sense, but what he said was, `I used to skateboard with you.' '' And you know what he meant by that? He actually used to skateboard with me. He was one of my high school friends who I had parted ways with, became schizophrenic, and had a completely different life than he deserved. And that was the point where it hit home to me that this can happen to anyone. Chairman Durbin. Thank you to this panel, and thanks to Ms. O'Donnell for being here earlier. We have left out a piece of this, which we could hold and probably will hold a separate hearing. Once incarcerated, what about the corrections officers? What happens in that setting? Now, we have had hearings here about segregation in incarceration, which usually means once incarcerated for a crime, you commit another crime while incarcerated. It turns out that many mentally ill people are destined to be found guilty of violating some rules and conduct because of a lack of understanding on both sides, from the corrections officer as well as the prisoner. And many times it leads to segregation, which makes the mental illness even worse. And then they are released, just to show the ultimate futility and inhumanity of the current system. So thank you for helping to put a perspective on this and helping us to understand it. We have so many organizations, over 100 organizations and individuals submitted statements for the record, and without objection, I will make them part of the record. [The statements appear as submissions for the record.] Chairman Durbin. I want to give a special shout-out to an individual, Lucius Outlaw, on my staff, who has done a lot of work on this hearing. He is an attorney on a 1-year detail from the Federal Public Defender's Office to this Subcommittee, and his detail is ending soon. I want to thank him for his good work on this hearing and in many other areas. We are going to keep the record open, and if there are questions from other Members, if you can respond to them in a timely fashion, I would appreciate that very much. Thank you all for attending today. [Whereupon, at 11:13 a.m., the Subcommittee was adjourned.] [Additional material submitted for the record follows.] A P P E N D I X Additional Material Submitted for the Record [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] [all]