Charleena Lyles Needed Health Care. Instead, She Was Killed.

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Photos of Charleena Lyles, who was killed by the police in Seattle on Sunday. Credit Ken Lambert/The Seattle Times, via Associated Press

On Sunday morning, two Seattle police officers shot and killed Charleena Lyles in her apartment. She was pregnant, and three of her four children were home. She had called the police to report a burglary. According to the officers’ account, shortly after they arrived, Ms. Lyles, who the police knew was mentally ill, pulled a knife. Both officers shot her. Societal failure to care for mental health, which leaves the police as mental illness first responders, may well have been one deadly ingredient in this tragic encounter.

According to her family and police records, Ms. Lyles wrestled with significant mental health issues. An audiotape reveals officers discussing her police and mental health history immediately before the shooting. Seattle Police Department officers had been called to her residence more than 20 times before this Sunday, with mental illness often figuring in those encounters. The department had placed an officer caution on her address for this reason, meaning officers should be on alert for dangerous behavior from her. Despite repeated previous mental health referrals and the involvement of Child Protective Services, she was alone with her children on Sunday, in distress and with nowhere to turn but 911.

Ms. Lyles’s situation is not unique. People with untreated mental illnesses are disproportionately likely to attract police attention. The combination of mental illness, racial segregation and poverty is particularly likely to result in police contact, often leading to arrest. In fact, a 2006 Bureau of Justice Statistics study revealed that 24 percent of state prisoners report a history of mental illness, with other sources reporting rates in some larger facilities as high as 70 percent. But it was not always the case that mental illness would result in the cycle of catch and release that evidently plagued Ms. Lyles.

What changed over the past half-century is that the United States has seen a stunning decline in resources devoted to public mental health — during the same time the nation adopted mass incarceration. A 2009 International Association of Chiefs of Police review reported that the available hospital beds for persons suffering from mental illness dropped by 95 percent from 1955 to 2005, to 17 beds per 100,000 persons from 340. From 1985 to 2005, the nation’s incarceration rate tripled.

The shift away from hospital treatment of mental illness was not matched by an offsetting commitment to fund the health care people needed to live on the outside. Medicaid reimbursement rates are so low that it is difficult to find providers who will accept it. As a result, many people with mental illness are functionally uninsured for their most urgent health care needs. That is, state support for mental health retreated at the same time state investment in incarceration exploded — and both with disastrous results for vulnerable communities.

The consequence of the disinvestment in public mental health has also not affected all vulnerable communities equally. African-American people are at least as likely as white people to experience mental health distress but are half as likely to receive mental health treatment. This helps to explain why it’s easy to recall other high-profile cases of police use of deadly force involving black victims with documented histories of mental illness.

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