By Cid Standifer for Eye on Ohio.
Broadcast version by Nadia Ramlagan for Ohio News Connection Collaboration reporting for the Ohio Center for Investigative Journalism-Public News Service Collaboration
An ambulance was already outside the East Side Cleveland home, its lights flashing, when the police officer arrived one evening in December 2020. According to body camera footage from the incident, the aunt of an 8-year-old with attention-deficit/hyperactivity disorder said the boy was "acting crazy." At one point, she said he had climbed out a window onto the house's roof.
"In some cases, the kid was probably traumatized," forensic psychologist Dr. Jeffrey Aaron said. "Not only is that bad for the kid in that moment, that leaves a kid with worse mental health problems, more animosity toward police, more likely that they're having behavioral problems down the road."
Rebuilding a crisis response policy
While studies estimate that only between 33% to 68% of 911 calls need to be handled by an armed officer, in Cleveland, officers are routinely summoned to deal with behavioral health crises. The city has joined a growing list of others experimenting with having social workers help respond to mental health crises. Sometimes, they accompany officers to emergencies, but more frequently they follow up with subjects later on.
Cleveland's police department has drawn national condemnation for deadly incidents involving both kids and people with mental illness. The 2014 fatal shooting of 12-year-old Tamir Rice by a Cleveland officer made headlines across the nation and dragged the department into a costly wrongful death lawsuit. The same year, Cleveland officers handcuffed Tanisha Anderson, a 37-year-old woman having a mental health crisis. She suffocated while in police custody.
Under a 2015 consent decree with the U.S. Department of Justice, department officials overhauled policies on use of force and crisis intervention, which went into effect two years later. They require officers to respond to people in crisis "in a manner that promotes the dignity of all people while reflecting the values of protection and safety," and outlined steps officers should take to deescalate situations. That includes: "Demonstrate empathy, concern, respect and a better understanding of the situation."
The new policies came with new training as well. According to the department's 2021 training report, 99% of the department's officers received basic eight-hour crisis response training. The training slides and instructor manual cover the crisis intervention policy, basic information about mental illness, and guidance on active listening and deescalation.
The department has also submitted curricula for in-service training, including one on traumatized youth that covers how teen brains react to trauma, and the best ways to interact with traumatized youth. While department officials didn't provide lists of training sessions and officers who attended them, a Case Western Reserve University assessment said 1,375 officers took the training in 2019.
In 2021, the department also implemented a new policy on dealing with young people. It calls on officers to take into consideration the child's age and developmental capacity, and warns that kids may react to police by running, not responding or being verbally abusive.
Experts: Some police escalate crises
Videos obtained by The Marshall Project - Cleveland and Eye on Ohio show that the new guidelines, for both people in mental health crises and children, weren't always put into practice.
Experts who watched the video of the 8-year-old said that the way the officer talked to the child may have escalated his distress.
"These (are) really kind of provocative baiting comments like 'You ain't no big man,'" Aaron, the forensic psychologist, said. "I would assume that part of that is an idea that, if you're going to be oppositional with me, it's with intent; 'You know what you're doing, and I'm going to win, and I'm just going to make that really clear.' But to an 8-year-old distressed boy, it's not going to come through that way."
Experts pointed out other instances where officers' behavior ramped up a child's stress.
In the footage of the 10-year-old girl, an officer can be heard questioning the girl in the same room as her mother and uncle, even though department policy states they should have been interviewed separately.
"Do you wanna see your mother die or something?" the girl's uncle interrupts. "You want to see something happen to your mother?"
Soon he is screaming at the girl. "You only get one mother. Do you hear me? You only get one fucking mother."
Eventually, the girl tries to cut herself, according to a conversation caught on body camera that included responding officers.
"Now you done did it," the officer said as the little girl wailed. "You're going to the hospital, little girl."
Jennifer Johnson, executive director of the Canopy Child Advocacy Center, which works with child abuse victims, said that the officer's words and tone as he cuffed the little girl were "definitely not OK."
"Saying it in that way comes across as a punishment or a threat, which escalates a crisis situation," Johnson said.
Lisa Thurau, the director of Strategies for Youth, a nonprofit which designed the department's training on how to interact with youth with mental illness, was alarmed by some incidents where officers seemed to rush toward grabbing or subduing a child.
"He went from arrival to (saying) 'Grab him' in a matter of seconds," Thurau said of the incident involving the 10-year-old hiding under the trampoline. "There was no introduction. There was no effort to establish rapport. ... There was simply a move for what would appear to be expedience to put him in cuffs and get out of there."
"Force is NOT to be used for expediency," the department's policy states.
In other cases where officers kept talking to kids, Thurau said she noticed initially hostile children opened up. Responding officers asked the 9-year-old with autism what was wrong for about eight minutes. Eventually, the child disclosed that he felt suicidal.
"It took them 20 minutes, but they really were able to engage in an actual conversation with that young man because they were so patient," Thurau said. "I mean, that was a tour de force."
In January 2022, when police were called about a boy who was menacing family members with a knife, the boy slipped out of handcuffs while in the back of a squad car and shattered a window, getting glass in the eye of one of the responding officers.
The officer struck by glass seemed unrattled, even as the boy screamed that he wanted to murder his mother.
"You can do all that another time and date, OK?" the officer said. "Listen, I need you to relax while we're here, OK?"
The officer calls for a shirt for the boy and speaks to him for the next hour as he is placed in an ambulance and taken to the hospital, encouraging him to take deep breaths with her and talk about why he was upset. Eventually the child began crying, asked for his mother, and said he needed help.
"I thought this officer was so wonderfully patient," Aaron said. "I thought she cared, and you could hear it, and I don't doubt that the kid heard it."
Handcuffing can be traumatic, psychologists say
In the video involving the 8-year-old boy being carried out of his home, he continues to resist after the officer tells him he's not a "big man." Three minutes later, inside the ambulance, the officer says to another adult that they'll need to handcuff the child to the gurney.
"Do you want to go in handcuffs?" he says to the child. Then, a moment later, "You gonna calm down, or do you want the other handcuff?"
The video provided by the police is almost completely blurred out, but a few seconds later, the child begins screaming. He keeps screaming and groaning for at least the next 15 minutes, the remaining duration of the video, until police leave him at the hospital.
Cleveland police department policies explicitly allow officers to handcuff juveniles when it's "objectively reasonable," even if they are only being detained for a psychiatric evaluation, not for any crime. The policy doesn't include any minimum age for a child to be handcuffed.
That's not the case in every jurisdiction. In Washington, D.C., there was an uproar after video came to light of police handcuffing a 10-year-old initially suspected of participating in a robbery. Department officials later changed their policy to say children under 12 should only be handcuffed if they were a danger to themselves or others.
In Kentucky, a federal judge ruled that a school resource officer who handcuffed a boy and a girl with ADHD was unreasonable and violated the Americans with Disabilities Act, even though the children hit and kicked teachers.
Cleveland police's crisis response policy warns that "handcuffs may trigger a traumatic response." It calls on officers to explain why they're handcuffing a person in crisis "in a tactful manner," and to use "age-appropriate language" when handcuffing children.
In the body camera video where officers pulled a boy from under a trampoline, police then walked the compliant, crying 10-year-old to a police car in the dark outside his home. One officer says to the other, "Just handcuff him. We can't have him going crazy in the back seat."
The police then struggle to lock handcuffs onto the boy's wrists as he stands still, quietly sobbing.
"Over two minutes, at least two minutes and 15 seconds - that's a long time - they didn't say a word to him during all this," Aaron said, "And to me, from the perspective of the kid, that could easily have been a very traumatizing event for him. It was dark. There were people he didn't know putting their hands on him."
Officers similarly ignored the 10-year-old girl who tried to harm herself as they drove her to the hospital, refusing to take off her handcuffs and then not answering when she asked why, body camera video shows.
She asked again for them to remove the cuffs 12 minutes later. The officer acknowledged her, but didn't answer when she said the cuffs were hurting her hands.
According to crisis response report data from 2020 through early 2022, Black girls were about 70% more likely to be handcuffed than White girls. After spotting the trend in 2021, the Mental Health Response Advisory Committee asked the Cleveland Police Monitoring Team to review body camera footage for all crisis response incidents where girls were handcuffed in 2021.
Each of the 26 videos was reviewed independently by two people. In most cases, reviewers thought the girls were treated with respect and courtesy, and that there was a good reason the child was handcuffed.
But half the reviews found officers did not explain why they cuffed a child. In eight reviews, they felt the handcuffing violated Cleveland Division of Police policy. Specialized Crisis Intervention Team officers were only summoned in five of the incidents reviewed. The officers volunteer for a 40-hour training course and are supposed to respond to crisis incidents wherever possible, according to Cleveland Division of Police policy. The report says officers' failure to call for the special units "is of particular concern given their enhanced training and critical importance to the effectiveness and success of the CIT Program."
There was only one crisis response report from 2021 where a 10-year-old girl was handcuffed. The report commissioned by MHRAC stated that in that case, an officer at the scene "did not seem to take the subject's complaints (of child abuse) seriously and had to be asked by the 10-year-old to listen to her side of the story."
The report also quoted the officer saying the girl was "acting like a jackass."
"The actions and comments of the officer are not consistent with the principles of (the crisis intervention team) or deescalation techniques and indicate a negative bias toward youth," the report concluded.
By contrast, Thurau said the officers who handcuffed the 9-year-old with autism did so as compassionately as they could.
In that case, the officers refrained from handcuffing the boy for about 20 minutes, even after he tried to climb over a fence to get away. When he tried to push past officers and run toward the street, they restrained and handcuffed him, then put him in a squad car to transport him to the hospital.
The officers let the child's mother sit in the back of the squad car with her son to calm him, and took the pair to their apartment so the mother could retrieve a few items. As they waited for the mom to return to the squad car, one of the officers removed the child's handcuffs.
"I'm sorry I had to put these on you to begin with," the officer told the child. "I'm not doing it to hurt you. I don't want to do anything like that. I'm not here to be your enemy."
Thurau said the interaction demonstrated how officers could make a crisis less traumatic.
"I'd love to meet that officer and shake his hand," Thurau said, "because he could teach others quite a lot."
Crisis intervention specialists
In the videos where young children in crisis were handcuffed, while they had likely been through the basic 8-hour crisis response training, none of the officers who were first on the scene had been through the 40 hours of training required to become crisis intervention team specialists.
The Marshall Project and Eye on Ohio requested one video where the child hadn't been handcuffed, and both the supervisor and one of the first responding officers on scene was a crisis intervention specialist. In that instance, officers didn't handcuff the child.
After a 10-year-old girl who'd been trying to harm herself storms out of her foster mother's house, screaming and overturning objects on the lawn, several officers follow her down the street at a distance for almost four minutes.
"This is ridiculous," grumbles Chris Eaton, the officer whose body camera footage was provided, out of ear-shot of the girl. "She should be grabbed, put in the back of the car and that should be that. Take her to the freakin' hospital."
It's not clear why from the video, but the girl is on the ground when Eaton reaches her. Officers are standing around her at arm's length.
"Young lady, my name is Chris Eaton," he says. "I'm a sergeant with the Cleveland Police Department. What's going on today?"
The 2017 Crisis Intervention Team policy suggests officers "Introduce yourself and seek to establish a rapport" as one de-escalation tactic.
After a brief exchange with Eaton, another officer offers to take the girl to the hospital.
The girl tells officers not to touch her, and says she'll get up by herself. The officer agrees.
"Have a seat in the car and we'll take you somewhere else," he adds. "Thank you."
She then gets in the car without the officers using handcuffs or physical force.
The slides for the Crisis Intervention Team officer training unit about youth with mental health problems advises, "Try to avoid touching an angry and potentially violent person." The training says that touching someone angry may trigger them to violence, while giving them space can let them cool down.
The week-long training schedule for Crisis Intervention Team specialists includes units on understanding schizophrenia, post-traumatic stress disorder, depression and other common mental illnesses; site visits to places like the psychiatric emergency room at St. Vincent's Hospital and community mental health providers; and one hour dedicated exclusively to youth and young adults' mental health.
There are currently 92 officers in the department who have completed the full training, and department policy calls for them to be deployed to crisis situations whenever possible. But only 17 percent of crisis response incidents said that at least one responding officer or a supervisor was a Crisis Intervention Team specialist.
Of the seven crisis response incidents where footage was provided, specialized Crisis Intervention Team officers were only requested in two, according to officers' reports.
The consent decree between Cleveland and the Department of Justice says that it should be the norm for Crisis Intervention Team specialists to respond to all calls where someone seems to be in crisis.
Cleveland Division of Police "policies and procedures will make clear that specialized Crisis Intervention Team officers, when available, must be dispatched to all calls or incidents that appear to involve an individual in crisis," the decree reads. "CDP will identify any barriers to ensuring that specialized Crisis Intervention Team officers were dispatched to these calls, and will include steps to overcome these barriers."
But, under the consent decree, the department is only required to have four training sessions for specialized Crisis Intervention Team officers.
Aaron, who frequently runs training for police officers, said that many are excited about training in understanding mentally ill kids, and are eager for more.
"I've trained many hundreds of police officers, and they get into policing I think by and large because they care about people and they want to help people," Aaron said. "Tools that help them do that should, I would think, be consistent with their personal and professional goals."
Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.
Cid Standifer wrote this article for Eye on Ohio.
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