People With Mental Illness Face Acute Dangers During and After Police Encounters

On February 25, 2019, Karrie Schaaf drove to the local emergency room, desperate to find help for her son Darik.

It was not the first time she had sought help. But because Darik, a Black man then in his mid-20s, was legally an adult, medical and psychiatric staff had repeatedly told her that they could not offer help unless he sought it himself.

This time, hospital staff called the police. When two deputies from the Riverside sheriff’s office arrived, Schaaf told them that her son was feeling suicidal and begged them to intervene. But, she recalled, no one went to their house to check on him. Exhausted, struggling with her own mental health, and worried that she might say something to make her son feel worse, Schaaf checked into a hotel for a few days. She emphasizes that, at no point, was she ever afraid of her son.

Three days later, the sheriff’s office asked her to come to the precinct. She panicked, assuming that Darik had died by suicide and they were asking her to identify his body.

When she arrived, she said that deputies interrogated her about her son’s behavior. Exhausted from work, sleep deprivation and constant worry, she tried to convey her fears that Darik might harm himself. What she didn’t realize was that her words would be used to justify arresting and charging her son with several felonies, which, if convicted, could mean a life sentence. Darik has remained in jail awaiting trial ever since.

Schaaf, who is white, emphasizes that she made a conscious decision not to call 911 on her Black son and instead turned to the local hospital for help. She had long known that calling 911 when Darik was in crisis could be a death sentence. Her fears are not unfounded: The Treatment Advocacy Center estimates that at least one quarter of all fatal police encounters are of people with serious mental illness. Furthermore, just as police are more likely to brutalize or kill Black men than their white counterparts, they are also more likely to kill unarmed Black men who exhibit signs of mental illness than white men demonstrating similar behaviors.

“I guarantee that if Darik were white, we wouldn’t be talking right now,” Schaaf said.

When questioned by police later, Schaaf attempted to make them understand that her son needed help. The entire ordeal, she says, stems from “asking for help — and look where we’re at.”

Schaaf didn’t realize that her son’s mental health crisis — and her pleas for help — could be twisted into a series of criminal charges with a possible lifetime prison sentence.

Darik’s situation is mirrored in other stories from around the country. Police-perpetrated violence against people with mental illness has gained more attention lately — but even those who survive encounters with law enforcement are not in the clear. People with diagnosed mental illnesses make up a disproportionate number of people behind bars. Nearly half (44 percent) of people in local jails and 37 percent of people in state and federal prisons have a diagnosed mental illness. Even when they are not prosecuted and imprisoned, becoming entangled in the legal system can have far-reaching ramifications for those diagnosed with mental illness and mental health disorders.

“Labels of Disability Can Be Leveraged to Confine People”

A diagnosis of mental illness can mean an increase in criminalization, advocates say.

“Labels of disability can and have been leveraged to confine people,” stated Dustin Gibson, co-founder of Disability Advocates for Rights and Transition. That confinement isn’t limited to jails or prisons; they also include psychiatric hospitals and facilities, which can hold people for lengthy, if not indefinite, periods of time under similar conditions.

“Disabled people cycle between jails and psychiatric institutions often,” noted Talila A. Lewis, an attorney and the director of HEARD, a cross-disability abolitionist organization. Lewis explained that if a person is arrested and their “competency” — or ability to understand the criminal charges and assist in their legal defense — is called into question by an attorney or judge, they are sent to a psychiatric institution (or sometimes held in the jail) for evaluation. A judge can order “competency restoration” if the defendant is found to be incompetent during a subsequent competency hearing. Restoration often involves coercive “treatment” including forced medicating. If deemed restored or restorable by “experts” and the court, the defendant will remain confined in a medical or carceral institution as they face criminal charges. Or, if the defendant is deemed not restorable or incompetent, after months or years of failed competency restoration measures, charges against them could be dismissed, but the person can be recommitted to a psychiatric institution for an indefinite amount of time using civil commitment laws. Alternately, they may be released only once they meet exacting residence, guardianship, and other requirements.

That’s the cycle that 43-year-old Siddharta Fisher has been pushed into for the past 25 years.

Her mother, Cindi Fisher, traces her entanglement with the criminal legal and psychiatric systems to her childhood — and the systemic racism she faced as an adolescent. In the 1980s, the Fishers were one of the few Black families in Vancouver, Washington (where Black people make up less than 3 percent of its population today). Nonetheless, the young Siddharta thrived in school, winning chess championships and academic accolades.

When she entered junior high, however, Fisher heard complaints from teachers who accused her child of disrespect. “But when I talked to [Siddharta], I found out it was because she was holding the teacher to the same rules they had for the kids. Like you don’t call the kids ‘knuckleheads’ or berate them. She would call the teachers on that,” Fisher recalled. This was in the 1990s. The term “school to prison pipeline” had yet to be created, but Siddharta’s experience reflected what was occurring in schools around the country — Black students were more harshly disciplined than their white counterparts. This included — and still includes — disproportionate rates of suspension and expulsion as well as arrests for incidents which could (and, advocates say, should) be handled internally by school officials.

That’s what happened to Siddharta. In seventh grade, she intervened when classmates stole another student’s coat. The next day, when she attempted to return it, the principal accused her of stealing it. When Siddharta wouldn’t name the culprits, the principal called the police, who arrested her and brought her to juvenile detention. She was confined for a week. That, Fisher said, changed the trajectory of her life. “[She] had always been taught that if she did the right thing, things would turn out right,” Fisher stated. That experience taught her otherwise.

Siddharta began skipping school and running away. At 15, she was arrested after a friend stole a gun from a classmate’s home during a party. She also began showing signs of dissociation, talking to herself and having breakdowns. At 17, after she stole his mother’s car, authorities recommended that Fisher bring Siddharta to a psychiatrist. The psychiatrist recommended risperidone, an antipsychotic drug used to treat schizophrenia and bipolar disorder.

Less than three months later, Siddharta began showing signs of akathisia, an acute movement disorder characterized by an inability to sit still. She also began self-mutilating — cutting and burning herself. She complained that the medications caused her pain, but, when Fisher brought her to the emergency room, physicians dismissed her complaints. One morning in June 1995, seven months after beginning risperidone, she woke her parents. The dead, she said, were coming through the floorboards. She accused her parents of poisoning her before leaving the house and knocking on doors in an adjacent neighborhood to seek help. When no one answered, she broke a window before collapsing in the street. When the police arrived, Cindi Fisher recounted, Siddharta told them she had been poisoned and begged to be brought to the hospital. Instead, they took her to jail.

Six months later, court evaluators declared her unfit to stand trial and ordered her to Western State Hospital for competency restoration. It would be the first of over a dozen arrests and hospitalizations.

The issue of confinement for “competency restoration” is a widespread one. In 2015, Disability Rights Washington and the American Civil Liberties Union filed Trueblood v. DSHS, a class-action lawsuit charging that Washington took too long to provide competency evaluations and restorations. Meanwhile, people languished in jails — often in solitary confinement and often without mental health care — exacerbating their conditions. A federal court agreed and ordered the state to provide competency evaluations within 14 days of a court order, and competency restoration services within seven days of the evaluation.

Even before the coronavirus pandemic, that timeline was met only an average of 24 percent of the time. In 2020, that number dropped to below 7 percent — and sometimes as low as 2 percent. That includes Siddharta, who, in 2020, spent four months in jail awaiting an evaluation and three additional months awaiting transfer to Western State Hospital for competency restoration. During those seven months, she was in solitary confinement, a common placement for those with mental health issues.

The idea of competency, noted Gibson, “can’t be divorced from a broad spectrum of disability because it’s built around the idea that disabled folks of all kinds need to be under surveillance and confinement.” This includes making a person’s release contingent on limiting where they can live or surrendering control over their own finances.

On April 12, 2021, Siddharta was approved for discharge. She remains confined until the social worker arranges housing through the approved social service agency. Fisher has said that she has informed the social worker of two programs which provide housing and peer support, enabling Siddharta to be discharged more quickly. “Over institutionalizing is no less harmful and illegal than discharging to the streets,” she wrote to the hospital administration on June 22, 2021. “Such overinstitutionalization, according to statistics, negatively impacts recovery gains, wasting taxpayers’ dollars, and increases Siddharta’s risk of reinstitutionalization.” [UPDATE: As of August 10, 2021, Siddharta has not yet been released, and her mother, Cindi Fisher, is on day 38 of a hunger strike to demand her child’s release.]

This surveillance and confinement is not limited to people experiencing mental illness which, Lewis noted, is in itself a disability. It also extends to people with other disabilities, including deaf people, and people with intellectual/developmental disabilities, traumatic brain injury, epilepsy and dementia, among other disabilities. Lewis also underscored that many disabled people have more than one disability.

Psychiatric Hospital Expansions

In 2018, the federal government pulled $53 million of annual funding from Western State Hospital for failing to comply with standards. Inspectors found that staff had restrained a patient for hours without cause; they also found violent assaults on patients and staff and numerous unauthorized patient “walkaways.” By then, the state had accrued more than $55 million in fines for repeatedly failing to meet the Trueblood timeline.

In 2021, the Washington state legislature approved plans for a new Western State Hospital with 350 forensic beds, or beds for those who have been deemed incompetent to understand the criminal charges pending against them. Lawmakers also announced the creation of smaller in-patient facilities for civil patients, or patients who are not facing criminal charges, by 2023, allowing Western and Eastern State Hospitals to concentrate solely on competency restoration.

However, says Lewis, these reforms do not challenge the problems with the idea of “competency” itself.

“The application of concepts of competency and due process are deeply flawed,” stated Lewis. “Ableism, anti-Blackness and other forms of oppression are baked into medical and legal processes and inform lawyers’, doctors’, judges’ and jurors’ understanding of a person’s competence, culpability and character.” Furthermore, Lewis noted that deprivation of freedom and bodily autonomy are being perpetrated under the guise of “securing due process,” “treatment” and “care” despite the fundamental unfairness of the criminal legal process and violence of medical incarceration.

Fisher doesn’t think that more psychiatric beds, even in smaller facilities closer to home, is the solution, pointing to a recent Seattle Times investigation exposing the failures of Washington’s private psychiatric hospitals.

Instead of smaller versions of the psychiatric hospital, Fisher wants alternatives where those in crisis can go “that’s not going to chain them up, lock the doors behind them, or force medicate them.” She is now involved in pressing for the resurgence of the Soteria House model. Started in the 1970s, Soteria House was a residential home for people newly diagnosed with schizophrenia. Instead of hospitalization and psychiatric interventions, Soteria House operated as a safe haven, similar to today’s peer respites, voluntary residential houses where nonprofessional staff treated residents as peers rather than patients in need of psychiatric intervention.

“We understand the need for respite for people who are wealthy, white, or otherwise in positions of power when they make the same request under a different name,” explained Lewis. “For them it is called vacation or sabbatical. But when people who are houseless or traumatized, or living through deprivation and precarity, need something similar, they are labeled lazy, pathologized, or criminalized.”

“A Concrete Cage Has Been My Son’s Reality”

Darik Schaaf remains in Riverside County’s Blythe Jail. His mother Karrie cannot afford the $1,040,000 bail set by the court or the 10 percent ($104,000) required by a bail bondsman. “My son has not been found guilty of anything, but because we’re poor, he’s been sitting in jail,” she said.

Despite being the alleged victim, Karrie says she has not been contacted by the district attorney’s office. “I’ve been very clear about my stance,” she told Truthout. “I’m not supporting these charges.”

The Riverside district attorney’s office did not return Truthout’s request for comment. In June 2020, it opposed Schaaf’s motion for a mental health diversion program. The judge agreed and ruled him ineligible for the diversion. Karrie Schaaf was devastated.

In January 2021, Karrie came across a post for the Riverside chapter of All of Us or None, a national network of formerly incarcerated people fighting for their rights. She attended a virtual meeting where she spoke about her son’s incarceration. She has also connected with family members whose loved ones have been fatally shot by police responding to mental health calls. Members have helped organize protests outside the district attorney’s office, calling for them to drop charges against Schaaf. They’ve also launched an online petition demanding that Darik be released into a mental health diversion program.

So far, their demands have not been met or responded to. Schaaf’s next court date is July 30, 2021.

“My son is not a criminal and having a mental health crisis is not a crime,” Karrie Schaaf told Truthout. “I struggle trying to understand how a concrete cage has been my son’s reality since March 1, 2019.”

CORRECTION: This article was amended on August 10, 2021 to reflect that Siddharta Fisher identifies as female and uses she/her pronouns.