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Philando Castile, Charleena Lyles, and PTSD: The consequences of fatal police encounters

Elizabeth​ ​Parris, MS and Marshall​ ​Fleurant, MD, MPH
Physician
October 1, 2017
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Fatal police encounters can engender PTSD in non-white communities and forever impact interactions with police. In​ ​the​ ​last​ ​few​ ​years,​ ​we​ ​have​ ​witnessed​ ​in​ ​horror​ ​the​ ​erosion​ ​of​ ​trust​ ​between​ ​public​ ​servants charged​ ​to​ ​protect​ ​the​ ​community​ ​and​ the non-white ​communities​ they serve.​ ​The​ ​killing​ ​of​ ​Philando​ ​Castile​ ​and​ ​Charleena​ ​Lyles​ ​compounded the​ ​horror,​ ​as​ ​their​ ​violent​ ​deaths​ ​were​ ​witnessed​ ​by​ ​their​ ​young​ children,​ ​spouses and,​ ​for​ ​Philando,​ ​social​ ​media. This trauma and similar events may result in symptoms related to post-traumatic stress disorder including nightmares, flashbacks, and hyperarousal.  We call for physicians and law enforcement to work collaboratively towards ending the cycle of negative police interactions and the resulting detrimental health effects.

Philando​ ​Castile​ ​was​ ​shot​ by police ​four​ ​times​ ​and​ ​died​ ​at​ ​the​ ​scene after informing officers that he had a legally concealed firearm.​​ His girlfriend live streamed the incident on Facebook while her four year-old daughter watched from the backseat of the car.  ​Charleena​ ​Lyles​ ​of​ ​Seattle,​ ​Washington,​ ​a​ ​single mother​ ​with​ ​a​ ​known​ ​mental​ ​health​ ​diagnosis,​ ​was​ ​killed​ ​by​ ​police​ ​in​ ​her​ ​own​ ​home​ ​after calling​ ​for​ ​assistance​ ​with​ ​an​ ​attempted​ ​robbery.  Her death was witnessed by her children.  How do these events impact a family or community?

Research has shown ​that​ ​exposure​ ​to​ ​physical​ ​abuse,​ ​sexual​ ​abuse,​ psychological​ ​abuse​ or other traumatic events ​leads​ ​to​ ​a​ ​higher​ ​prevalence​ ​of​ ​alcoholism,​ ​illicit​ ​drug​ ​use,​ diabetes,​ ​emphysema,​ ​and​ ​heart​ ​disease​ ​as​ ​​compared to ​the​ ​general​ ​population.​ ​We​ ​can​ ​all​ ​agree​ ​that​ ​the​ ​children​ ​of​ ​both​ ​Philando​ ​and​ ​Charleena​ ​Lyles​, although​ ​not​ ​shot​ ​themselves,​ ​experienced trauma as a result.​ These children are​ ​at significant​ ​risk​ ​of​ ​developing​ ​symptoms​ ​related​ ​to​ ​post-traumatic​ ​stress​ ​disorder.​ ​​ ​This​ ​risk also extends to ​community​ ​members​ ​of color,​ ​who​ were traumatized by viewing ​the​ ​death​ ​of​ ​Philando​ ​Castille repeatedly on​ ​social​ ​media, yet who must also manage their emotions in future encounters with law enforcement.​ ​​

​Due​ ​to unconscious ​racial bias​ ​against​ ​non-white​ ​people,​ ​police​ may ​overreact​ ​​​to​ ​non-threatening behaviors​ ​and​ ​language. Citizens​ and police officers with​ ​PTSD​ ​commonly​ ​react​ ​with​ ​hypervigilance,​ ​increased arousal,​ ​irritability,​ ​and​ ​an​ ​exaggerated​ ​startle​ ​response.​ The combination of traumatized citizens and traumatized, racially biased police ​can easily result ​in​ ​major​ ​miscommunications​ ​which,​ ​in​ ​turn,​ can ​lead​ ​to more fatalities​.  ​​​Unless we commit to finding appropriate preventative strategies, we​ ​risk repeating​ ​the​ ​cycle​ ​of​ ​negative​ ​interactions​ ​with​ ​police​.

We must recognize​ ​the​ ​horrible​ ​tragedy​ ​directly​ ​experienced​ ​by the​ ​victim’s​ ​loved​ ​ones during these traumatic events.We must be cognizant of the​ ​implications​ ​these events have​ ​for​ ​an​ ​entire​ ​demographic​ ​that​ ​fears​ ​for similar​ ​experiences. Most importantly, we must ensure that the affected families and communities ​have access to ​appropriate​ ​programs​ to manage their grief and trauma.​ ​Cognitive​ ​Behavioral​ ​Therapy​ ​has​ ​been​ ​shown​ ​to​ ​be​ ​effective at minimizing​ ​immediate​ ​negative​ reactions to trauma​ ​and​ ​preventing​ future illnesses that may develop​.​

​We must also endeavor to prevent such events from occurring the future. Law enforcement agencies should avail themselves of tactics proven to reduce such traumatic events ​such as​ ​implicit​ ​bias​ ​training, diversion​ ​tactics​,​ ​and​ the use of ​embedded mental​ ​health​ ​workers during selected encounters with the public.​ ​The​ ​Memphis​ ​Crisis Intervention Training (CIT) ​​model​ ​is​ ​one example.  ​The​ ​program​ provides law enforcement officers with ​40​ ​hours​ ​of​ ​training​ ​provided​ ​by​ ​mental​ ​health​ ​clinicians, consumer​ ​and​ ​family​ ​advocates,​ ​and​ ​police​ ​trainers.​ ​Studies​ ​​found​ ​that​ ​CIT​ ​officers​ ​used​ ​force in​ ​only​ ​15 percent​ ​of​ ​encounters​ ​rated​ ​as​ ​high​ ​violence​ ​risk,​ ​and​ ​​​when​ ​they​ ​did​ ​use​ ​force, they generally​ ​relied​ ​on​ ​low-lethality​ ​methods. ​The​ ​CIT​ ​program,​ ​to​ ​date,​ ​​​has​ ​reduced​ ​arrests​ ​and increased​ ​safety​ ​and​ ​diversion​ ​to​ ​mental​ ​health​ ​services.

​One​ ​may​ ​argue that​ ​it​ ​is not​ ​the​ ​responsibility​ ​of ​law enforcement​ ​to​ ​find​ ​a​ ​solution.​ ​ ​However, traumatized,​ ​hypervigilant​ ​citizens​ ​are​ ​a​ ​danger​ ​to​ ​self,​ ​community​ ​and​ ​the​ ​police, so it is truly in everyone’s best interest to employ diverse​ ​solutions​ to ​end​ this ​cycle​ ​of​ ​traumatic​ ​police​ ​encounters.

To end this cycle, we must ​reframe​ ​the​ ​perspective​ ​of​ traumatic ​police​ ​interactions​ ​and​ adapt ​a​ ​therapeutic approach, with both prevention and treatment. To prevent, we must change ​the​ ​way​ ​we​ ​train​ ​our​ ​police. To treat, we must ensure that those who have had and/or witnessed traumatic encounters receive the support they need. By taking these steps, ​we hope to interrupt this vicious cycle of trauma, and restore the trust in law enforcement that these communities have lost.

Elizabeth​ ​Parris is the assistant​ ​director​ ​and Marshall​ ​Fleurant is a member, respectively,​ ​Physicians​ ​for​ ​Criminal​ ​Justice​ ​Reform (PfCJR)​-​Mental​ ​Health Task Force.

Image credit: Shutterstock.com

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