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Hard lessons from Daniel Prude’s death: The Rochester tragedy didn’t need to happen

By CHERYL ROBERTS, OPINION, NEW YORK DAILY NEWS, SEP 15, 2020

This undated file photo, provided by Roth and Roth LLP, shows Daniel Prude. Prude, 41, apparently stopped breathing as police in Rochester, N.Y. were restraining him in March 2020 and died when he was taken off life support a week later. Rochester Mayor Lovely Warren fired the police chief and suspended her top lawyer and communications director Monday, Sept. 14, 2020 in the continuing upheaval over the suffocation death of Daniel Prude. (AP)

Daniel Prude represents the most at-risk group of Americans to be killed in an encounter with police: a Black male living with a serious mental illness.

When police are summoned to so-called Emotionally Disturbed Person (EDP) calls, the results are often deadly. Nationwide, at least a quarter and maybe as high as half of those killed by police had mental illness. But the police alone do not own this statistic. The mental health system can be ineffective and racist too when it comes to African-Americans in mental health crisis.

Like Darrien Walker, killed by police only hours after release from a short-term stabilization center, Prude was seen by medical personnel shortly before his fatal encounter with police. While the hospital has promised a thorough review of the procedures and personnel involved, there will likely never be a complete public accounting should it be found that medical professionals were also at fault or that implicit bias was at the heart of why Prude was released that day without receiving help.

In many ways, America’s health-care system is just as racist as its criminal justice system, but there are no body-worn cameras to document how many times Black people are dismissed or ignored by the health-care system or its professionals. A 2018 Commonwealth Fund study documented disparities in treatment and outcomes between Black and white patients; poorer disease outcomes, instances of physicians not taking time to explain diagnoses and options, disrespectful front-desk staff, and general lack of support in dealing with complications involving Black patients.

When it comes to mental health care, the picture is even more disturbing and confounding. While only one in three African-Americans receive the mental health care they need, research also shows that Black people are more often misdiagnosed with psychotic disorders than Euro-Americans, and Black men are three to five times more likely to be diagnosed with schizophrenia than white men. It is unclear why, but some researchers believe this could be attributable to cultural bias.

Others suggest it is a contemporary version of “racist thinking” dating to the 18th century, when “[s]lave owners and their apologist physicians invented psychiatric ‘disorders’ such as ‘draeptomania’ to explain the urge to run away.” One can wonder if “excited delirium,” a term first appearing in a 1849 American Journal of Insanity article and used to describe Prude’s condition, as well as justification for the deaths of many others killed by police, is just another version of “draeptomania.”

Yet when it comes to deaths of people in mental health crisis by police, the rote response is a call for more Crisis Intervention Team (CIT) training, even though a 2019 American Academy of Psychiatry and Law Journal article found “[t]here is little evidence in the peer-reviewed literature, however, that shows CIT’s benefits on objective measures of arrests, officer injury, citizen injury, or use of force.” It does, however, seem to improve “officer satisfaction and self-perception of a reduction in use of force” and may lead to more jail diversion.

To be sure, police need more training and accountability, but they also need to not be our first responders to mental health crises. People like Daniel Prude deserve full access to unbiased mental health treatment. We don’t know precisely what type of care he received, but the odds are, he didn’t get what he needed.

He may have needed mandated community treatment, through Kendra’s Law, which allows judges to place those with serious mental illness into mandated and monitored treatment for up to one year if they have a history of multiple arrests, hospitalizations and an inability to comply with treatment.

He may have needed stable supportive housing, which is documented to result in fewer ambulance rides, days in substance use residential treatment and psychiatric hospitalizations, and reduced recidivism rates, including the number of felony convictions.

What he didn’t need was to die at the hands of police.

Roberts, a former town judge, is executive director of the Greenburger Center for Social and Criminal Justice.

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