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Departments : Think It Through

Mental Illness Suicide Attempt

A knife-wielding man threatening self-harm has cut himself and family members trying to intervene. How will you respond?

June 09, 2016  |  by Amaury Murgado - Also by this author

In every call for service, you should think things through before you begin your response. Each call can be broken down into three phases: pre-response, response, and post-response. The following scenario is designed to help you think things through rather than give you a specific way to handle the call.

Situation

You get a call of a suicidal adult male who has a history of mental illness. He has been depressed, got into an argument with his mother, and has armed himself with a sharp kitchen knife. He has already started cutting himself in desperation and moved outside. The mother and sister are trying to stop him from using the knife and in doing so have been cut themselves. The sister has been talking to him and he seems to be calming down. He is covered in his own blood. The mother is on the phone with dispatch, crying, and asking for help before her son kills himself.

Initial Thoughts

You need to get there fast. You need to confirm if any responding officer (on or off duty) has a less than lethal capability. You know your agency has four 40mm launchers that shoot rubberized projectiles, but none are assigned to your squad. You need to worry about contact with the subject's blood so you have to remember to glove up and use universal precautions where you can.

You have to remember you are not dealing with a violent criminal but a mentally ill person. It may come to using deadly force but you hope to avoid it. In the back of your mind you make a mental note about the possibility of the subject going mobile, which may necessitate a broader response.

Pre-Response

Think It Through Questions

  • Can you confirm the subject's mental illness?
  • What types of precautions can you take against possible blood contact?
  • If there are no less-lethal options, what is your best move?
  • How do you keep the subject from hurting himself or others, or taking a family member hostage?

Your supervisor is nowhere near. That means that the senior officer (you) is in charge until she gets there. You assume command and see what unit is closest. You advise the unit to make a calm approach, move the mother and sister away from the subject, and try to keep him talking. You advise all responding officers to put on their gloves before they arrive. You advise dispatch to have EMS stage outside the subdivision. You confirm that there will be at least three of you going to the call.

Response

Think It Through Questions

  • How do you secure the scene?
  • What if the subject runs back inside the house?
  • How do you address his injuries?
  • How do you deal with the knife without a less-lethal option?

As you pull up, you notice that the subject, mother, and sister are all covered in blood. You don't know if it's his or theirs. One officer is near the mother and sister, and the other is on the opposite side of the subject. The sister is still talking with the subject and things seem to be calming down. You walk up very calmly and take a middle positon between your two officers. You stay a safe distance away from the suspect. You say hello to the subject in a friendly way and note he still has the knife in his hands.

As you start to talk to him, the mother yells, "Please don't kill him! He is just sick!" The subject gives you that look and bolts for the front door. You are the closest to him so you sprint to the door. He gets to it first and makes it inside. You have no choice but to slam through the door.

As you make it in, the subject runs to the back of the house in an apparent attempt to run outside through the sliding glass doors. You don't see the knife in his hands anymore so you run after him. You end up circling back to the living room and you go in for a take-down. Since he is covered in blood your hands slip right off. You are too close so you transition to a hip throw but he grabs your uniform and you both crash down onto a glass table. You land on top of the subject but as you try to gain control, he kicks you off of him into a nearby bookcase. You wonder where your backup is. It seems like forever before they make it through the door. When they do, you finally get control of the subject.

You call EMS in and they take care of everyone's injuries. Luckily, they have superficial injuries and no one was seriously hurt. The mother and sister are grateful for the way the call was handled. The mother says that where they used to live, three police officers had roughed up her son during a similar call and that's probably why he ran when you arrived on scene.

You follow the subject to the hospital where he is held for mandatory observation for evaluation and treatment. You and your two other officers are covered in blood and follow your agency's protocol for possible exposure to bloodborne pathogens.

Post-Response

Think It Through Questions

  • Could you have gotten more information beforehand?
  • Was there a better approach?
  • What if the subject had made it to the kitchen and armed himself again?
  • Why was there hesitation from the other two officers?

While you and the other responding officers wait to get checked out for exposure to bloodborne pathogens, there is plenty of time for the three of you to discuss the situation. You find out there was no hesitation; it just seemed that way to you. The other officers were actually farther away from the door than you were and then got jammed up at the door as you went in for the takedown. What seemed like forever to you was just a few seconds to them.

You discuss the lack of less-lethal options and agree that someone up the chain of command needs to consider buying more or coming up with a system where a launcher is at least available to every squad. The other officers volunteer you to write the memo. You also agree that more training on how to handle mentally ill subjects is necessary.

Final Thoughts

When it comes to using force, there is a fine line between how you deal with a mentally ill person and a violent criminal. You have the right to defend yourself in either case. The need to deal with mentally ill people is not going away. It needs to be addressed with consistency and recurring training. Failure to do so may end up in tragedy for all those involved.

This scenario was based in part on a call I had to handle as a new sergeant. I will never forget the blank stare in the subject's eyes or how strong he was. As soon as we tried to obtain control, he threw us around like we were rag dolls. To this day I am grateful I didn't have to shoot him and that he got the treatment he deserved.
There are always multiple possibilities and potential responses. Thinking it through now saves you time later.

Amaury Murgado retired a senior lieutenant from the Osceola County (FL) Sheriff's Office with over 29 years of experience. He also retired from the Army Reserve as a master sergeant. He holds a Master of Political Science degree from the University of Central Florida.


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