The Dec. 25 shooting death of a mentally ill man by Palo Alto police has raised questions regarding the officers' crisis training before they fired at 31-year-old William David Raff. Police say he was screaming in the street and charged in the darkness toward officers while waving what turned out to be a dinner knife.
The whole incident lasted just 19 seconds.
Encounters between police and people who have a mental illness are not uncommon. Palo Alto officers placed 1,760 people in crisis on 72-hour psychiatric holds -- an average of 176 per year -- between Jan. 1, 2006, and Dec. 27, 2015, Palo Alto police spokesman Lt. Zach Perron said. Last year's figure was the highest in a decade: 239.
To prepare for possible crises, police departments statewide are required to offer a few hours of crisis-intervention training when officers are in the academy. More recently, police departments are adding a 40-hour Crisis Intervention Training (CIT) program.
Perron said the crisis training, which includes role playing to interactive videos of people in crisis, has proved crucial in saving the lives of police, persons in crisis and victims caught up in the incidents.
"I was one of the first officers to go through the program, and it is of exceptional value. I have used the training repeatedly throughout my career any time I encounter someone in a mental health crisis," he said.
About 90 percent of Palo Alto's officers have received the training, Perron said. He would not comment on whether the officers involved in Raff's death are among them, citing the privacy of personnel records. But given the high number of trainees in the department, "You could read between the lines," he said.
Palo Alto police use Interactive Videos Scenarios Training. Simulated persons with a mental health crisis change their responses based on the officer's reactions. Former Palo Alto Police Chief Pat Dwyer led the development of the program.
Palo Alto's force is the exception rather than the rule, however. Most departments only have a small number of officers trained at the 40-hour level, law enforcement professionals and observers said.
LaDoris Cordell, former Palo Alto City Councilwoman and San Jose's former independent police auditor, is one of those observers who is concerned about the lack of widespread training.
"In some departments all new officers have to take 20 to 40 hours of CIT, but the problem is that they are given the training before they have had any real experience on the streets," she said. "They are so overwhelmed with all of their training that the CIT doesn't stick. New recruits, in my view, should have CIT about six months after they have been on patrol with their field-training officers.
"CIT should be mandatory, not voluntary, and retaken every two years, and I think that every officer should take it, from the top (chief) on down," she said.
Former Palo Alto Mayor Vic Ojakian, president of the Santa Clara chapter of the National Alliance on Mental Illness (NAMI), said he believes that crisis training is effective, but a refresher training would be useful and valuable.
"But no training is fool proof. ... Circumstances and situations can influence how the training is applied," he said.
To help departments prevent encounters with mentally ill persons from becoming crises, some departments are experimenting with teams that include mental health practitioners.
Jason Albertson, a licensed clinical social worker with San Mateo County's Behavioral Health and Recovery Services, is a member of the county's new pilot psychiatric emergency response team, which was launched last March.
Albertson partners with San Mateo County Det. Jim Coffman, and together they go out to advise police during incidents and also to aid the person in need once the situation is no longer considered dangerous. Coffman and Albertson can typically spend three to four hours with the person in distress, helping them to develop a care plan -- medication renewals, finding a treatment program or sober housing -- that will hopefully prevent further police contact or escalating crises.
"That's not something police officers are trained to do or will have the time to do," Albertson said.
Albertson can access the person's medical records and find out why the person is behaving irrationally, such as if they have had treatment in the past or if they have run out of medication.
Coffman and Albertson currently work daytime shifts in the unincorporated areas of the county, along the transit corridors and in cities that contract for law enforcement with the sheriff's department: Woodside, Portola Valley, San Carlos, Millbrae and Half Moon Bay.
The team scans dispatch calls and receives requests to come to crisis situations. Since March, they have responded along with police to 22 crisis situations and placed nine people on psychiatric holds. In total, they've aided 179 people, some multiple times.
The pilot program was borne out of a 2014 tragedy very similar to the one in Palo Alto.
A deputy sheriff responding to a 911 call asking for medical help by the family of Yanira Serrano-Garcia shot and killed the Half Moon Bay teenager less than a minute after arriving. Serrano-Garcia, who had severe mental illness, allegedly wielded a knife and headed toward the officer, according to news reports.
Stephen Kaplan, director of the county's Behavioral Health and Recovery Services, said that his department and law enforcement had been talking about the gaps in their overall crisis-response system, but Serrano-Garcia's death was the catalyst for the pilot.
Albertson and Coffman also try to get to people early, before a crisis erupts that would require police intervention, Kaplan said.
"We know people with severe mental illness are going to have a crisis. Our goal is to prevent them from getting hurt or killed and to prevent law enforcement officers from getting hurt or killed," he said.
For example, Albertson said, if a 17-year-old has gotten into a fight with his mom and threatened to kill himself, he and Coffman will go to the home to assess if the teen needs care. If a weapon is involved or the person is a threat to themselves or others, they can place the person under a 5150 hold.
On Wednesday morning, Coffman and Albertson searched for a man with multiple physical and mental health issues and alcohol dependency who could be in crisis. It's not the first time they have interacted with him. Looking for recognizable signs of his presence, they knew they were getting close when they spotted his backpack and possibly his wheelchair. Addressing his issues took most of the afternoon.
The success of Coffman's and Albertson's preventive work is often measured in non-quantitative ways, they said. Arriving at the home of a man with schizophrenia who was becoming violent, they learned that he kept toy weapons. The toys looked like real weapons: a shotgun or rifle, knives and a handgun that fired BBs. The man's father gave the toys to Coffman and Albertson to take away, a small act that may have prevented the man's death.
"If an officer had come to that door and he had displayed something that looks realistic, he could have been shot," Albertson said.