The City of Oklahoma City and its police department “engage in a pattern or practice of conduct that discriminates against people with behavioral health disabilities when providing emergency response services” in violation of federal law, the U.S. Department of Justice said in a 45-page report released today.
“Oklahoma unnecessarily institutionalizes, or puts at serious risk of unnecessary institutionalization, adults with behavioral health disabilities in the Oklahoma County area, in violation of Title II of the Americans with Disabilities Act,” the report states. “Together, the deficiencies in Oklahoma County’s behavioral health service system and Oklahoma City’s emergency response system lead to an unnecessary cycle of hospitalization and law enforcement contact.”
The DOJ report concludes by suggesting the federal agency could file litigation against the state and city if steps are not taken to ameliorate local emergency response processes and behavioral health care services.
“We find that Oklahoma fails to provide services to adults with behavioral health disabilities in the Oklahoma County area in the most integrated setting appropriate to their needs. Due to insufficient community-based services, Oklahoma relies unnecessarily on psychiatric hospitals and residential care and nursing facilities to serve adults with behavioral health disabilities who could be appropriately served in their own homes and communities,” the report states. “We further find and have reasonable cause to believe that Oklahoma City and OKCPD engage in a pattern or practice of conduct that deprives people with behavioral health disabilities of their rights under federal law, by failing to make reasonable modifications to and denying them an equal opportunity to benefit from the emergency response system. Oklahoma City and OKCPD’s unlawful practices harm community members and undermine public safety.
“We are required to advise you that if we cannot reach a resolution, the United States may take appropriate action, including bringing a lawsuit, to ensure compliance with the ADA.”
Drummond: DOJ report ‘an attempt to bully Oklahoma’
Stemming from an investigation announced in November 2022, the DOJ report comes amid increasing turmoil about how the state of Oklahoma and municipalities in Oklahoma County handle people dealing with mental illness who are accused of criminal activity. State leaders are in the process of settling a class-action lawsuit to address unconstitutional delays in mental health competency restoration services for pre-trial detainees, and they also face a massive funding shortfall that is delaying completion of the new Donahue mental health hospital in OKC.
At the municipal level, the City of OKC has faced a pair of federal lawsuits related to the 2020 fatal police shootings of 15-year-old Stavian Rodriguez and 60-year-old Bennie Edwards, an unhoused man with a history of mental illness who was shot in the back by an Oklahoma City Police Department sergeant while running away from officers in a parking lot. In Edmond, city leaders have faced questions over how at least seven 911 calls related to the mental health of Ross Norwood spurred no intervention for weeks until he lit his porch on fire and was shot by police.
More recently, an OKCPD sergeant was charged with aggravated assault and battery for body-slamming 71-year-old Lich Vu during an argument over a traffic citation. While Oklahoma County District Attorney Vicki Behenna charged the officer who inflicted facial and spinal fractures upon Vu, Attorney General Gentner Drummond took over and dismissed the case last week while saying Vu should have “kept his hands to himself” instead of tapping the officer on his chest during their disagreement. Drummond’s decision was lauded by the OKC Fraternal Order of Police lodge but widely criticized by some members of the public, including both Republican and Democratic legislators.
On Friday, Drummond released a statement criticizing the DOJ report minutes before the federal agency had even posted it online.
“While I strongly support reform of the mental health system, I am wary of yet another top-down approach in this 11th-hour report by the Biden administration’s Department of Justice,” Drummond said. “We will closely review the findings, but the DOJ report appears to be an attempt to bully Oklahoma into compliance with ever-changing and undefined targets. Such federal overreach has been part and parcel with this White House.”
Drummond has pushed the state of Oklahoma to approve a consent decree and settle the federal class-action lawsuit regarding mental health competency restoration services for pre-trial detainees. A consent decree formalizes an agreement for a government to improve services or address deficiencies over a period of time.
In its press release announcing the Oklahoma and OKC report, the DOJ noted that it had opened 12 “pattern and practice investigations into law enforcement agencies” since 2021. As a result of those investigations and reports, the DOJ said it has “successfully concluded agreements and portions of consent decrees” with five law enforcement agencies across the United States:
- the Yonkers Police Department (New York);
- the Suffolk County Police Department (New York);
- the Albuquerque Police Department (New Mexico);
- the Portland Police Bureau (Oregon); and
- the Seattle Police Department (Washington).
Kristy Yager, OKC’s director of public information, said city officials were “reviewing the findings” of the report.
“The report was not shared with the city prior to its release and the process to analyze and consider its contents will take time,” Yager said. “The city remains focused on providing the best services to its residents now and into the future.”
DOJ report details 988 failures, service shortfalls
As an example of the deficiencies in Oklahoma City’s behavioral health system, investigators with the DOJ’s Civil Rights Division told the story of “Serena,” who was 27 years old when she died of a drug overdose.
“The lack of services in Oklahoma County meant that she often had to wait a long time to get an appointment with a community provider, and the services she did receive were not intensive enough to help her live successfully in the community,” investigators wrote. “In the two years leading up to her death, Serena had at least five psychiatric inpatient stays. When in crisis, she regularly sought out crisis services but was typically turned away without any treatment to help stabilize her symptoms.”
According to the report, Serena “had regular contact with OKCPD” and spent “much of the last year and a half of her life in jail.
“She ultimately died by overdose after not receiving behavioral health care that would have helped her live successfully in the community and avoid unnecessary encounters with the police,” the report states.
The report also examines an open secret among Oklahoma behavioral health professionals and law enforcement organizations: that police officers are routinely dispatched to calls about people experiencing mental health crises owing to “insufficient” availability of alternatives, such as mental health crisis or PACT teams. The report tells the story of “Rachel,” who noted the inefficacy of Oklahoma’s 988 mental health line as an alternative to 911.
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“The insufficiency of mobile crisis also leads to avoidable interactions with the police, who may be called to respond if a mobile crisis team is not available,” the report states. “Rachel tried to call 988 for her brother when he was having a behavioral health crisis, but she was only given the option of a police response and was told that a non-police response was not available. Eventually her brother’s situation escalated so someone else called the police, who arrested him and took him to jail.”
DOJ investigators wrote that “OKCPD itself reports that 988 frequently transfers calls to the 911 center that are not appropriate for a police response.”
“A big problem with that whole situation was that I was relying on 988 to help and it was not helpful,” Rachel is quoted as telling the DOJ. “If anything, it was harmful — on top of them not helping, it wasted time and allowed someone else to call 911 in the meantime.”
When mobile crisis teams do respond, investigators wrote, they are more focused on whether someone needs hospitalization instead of connecting them with ongoing services in the community “as the state’s mobile crisis services are intended to do.”
“Facilitating access to facility-based treatment takes less time than resolving the crisis where it occurs, but it undermines the efficacy of the mobile crisis team and leads to avoidable hospitalization,” the DOJ report states. “As a result, people in crisis sometimes receive almost no help from mobile crisis.”
As a result, investigators noted that many people experiencing mental health disorders end up in the troubled Oklahoma County Jail, which has seen a slate of deaths in recent years as the city and county fight over where to build its replacement.
“The lack of community-based services also contributes to high rates of behavioral health-related calls to 911. In 2023, OKCPD logged at least 18,614 behavioral health calls for police response,” the report states. “Many of the crises leading to those calls could have been prevented with access to appropriate community-based behavioral health services. And for many adults with behavioral health disabilities in Oklahoma County, the county jail has become the default behavioral health provider.”
Investigators wrote of a woman named Michelle, who requested mobile crisis response for her daughter, Ariel, three times.
“On each occasion, the mobile crisis team either called the police or determined that Ariel did not meet criteria for facility-based treatment. But the mobile crisis team provided no additional assistance once they determined she was not appropriate for inpatient care and did not connect her to ongoing services,” the DOJ report states. “Once, after Michelle and Ariel waited for more than two hours for a team to arrive, the mobile crisis team did nothing except call the police. Although Ariel continues to need crisis support, her mother has not used 988 since, saying ‘I can call the police myself.’”
Like Drummond, Gov. Kevin Stitt and Oklahoma Department of Mental Health and Substance Abuse Services Commissioner Allie Friesen released statements Friday dismissive of the DOJ’s findings.
“This is another Biden administration overreach on their way out the door,” Stitt said. “Allie Friesen and her team are working hard to reform our mental health system, but they can’t do that if they’re burdened with heavy handed, out of touch mandates from the federal government.”
In her statement, Friesen made an aggressive claim that contradicts the report: “Oklahoma continues to lead the way in mental health care, guided by evidence-based practices and national standards.”
“While tragic stories exist, as in any health system, the DOJ focuses on a select few cases to overshadow what it acknowledges are the state’s laudable efforts to build out its crisis system in recent years,” Friesen said. “We disagree with the report’s adverse findings as well as the DOJ’s subjective recommendations on how we should run our mental health system. As the report itself notes, the DOJ’s recommended remedial measures are consistent with the priority areas the state already identified in the comprehensive 60-page action plan we previously provided to DOJ.”
DOJ report outlines recommendations to avoid litigation
DOJ investigators concluded their report with a list of “remedial measures” that include:
- Increasing the availability of community-based services — such as Program of Assertive Community Treatment (PACT) teams, permanent supported housing, case management, peer support services and Individual Placement and Support — to ease the burden and cost of hospitalization and institutionalization;
- Increasing proactive outreach to connect people to mental health services that allow them to avoid prolonged hospitalization;
- Strengthening connections between institutions and community services to allow more people discharged from hospitals to remain in constant contact with community-based programs and decrease rates of readmission;
- Developing “behavioral health mobile response teams” that can respond to situations where police are not needed;
- Ensuring clear policies for 911 operators to know what response is most appropriate for a particular call;
- Ensuring OKCPD officers know how to respond to people with behavioral health disabilities;
- Increasing capacity of the 988 mental health hotline and its communication with the 911 center; and
- Increasing communication between the Oklahoma City, OKCPD and the state to share information and data with service providers.
Read the full DOJ report on mental health system deficiencies
(Correction: This story was updated at 2:35 p.m. Friday, Jan. 3, to correct reference to a lawsuit filed against the City of Oklahoma City.)
