Mission

The Center for Law, Brain & Behavior puts the most accurate and actionable neuroscience in the hands of judges, lawyers, policymakers and journalists—people who shape the standards and practices of our legal system and affect its impact on people’s lives. We work to make the legal system more effective and more just for all those affected by the law.

The Trials of Teresa Sheehan

By Sandra Allen | BuzzFeed | July 9, 2015

On Thursday, Aug. 7, 2008, a social worker named Heath Hodge arrived at a three-story residence in San Francisco’s Mission District. Hodge was employed by a nonprofit called Conard House, which runs several cooperatives for adults with mental illnesses throughout the city. As Hodge climbed the stairs to the bedrooms on the second floor, one resident in particular was on his mind. 

Teresa Sheehan was 56, Japanese-American, and about 250 pounds. She had been with Conard House for over three years. Her diagnosis was schizoaffective disorder, which combines the swings of mania or depression with schizophrenia’s psychosis. Hodge had heard from other residents that Teresa had stopped attending house meetings, eating, and changing her clothes. She had also not been taking her medications for some time, potentially for as long as a year and a half. According to her family, she had long disputed that she had a mental illness.

Teresa’s room was at the end of a hallway. When Hodge knocked on her door she didn’t answer. With a property manager’s help, he unlocked it. The room was small and cluttered. It had a window at the far end. Teresa was lying on her twin bed with a book over her face.

Startled, rising, Teresa told them to get out of her room. She shouted that they had no right to be there and that she had a knife. Hodge later testified he didn’t see a knife at that time. He also testified that she threatened to kill him; the property manager didn’t hear this.

In California, as in much of this country, treating people with psychiatric disabilities without their consent is hard to do. As a social worker, Hodge had a card authorizing him to place someone like Teresa on an involuntary psychiatric hold (which is known colloquially as a “5150,” referring to the California statute number). But he can only do so under a few, extreme circumstances: if an individual is gravely disabled or a danger to him or herself, or to others — like if she threatened to kill someone.

Otherwise, even if he believed Teresa Sheehan needed psychiatric care, Heath Hodge couldn’t force her to receive it. Because of laws protecting patient privacy, he also couldn’t have told a trusted family member or other caregiver what was going on. Teresa’s older sister Patricia lives about 15 minutes away from that house.

Hodge went to his car to retrieve a pink 5150 form and called the San Francisco Police Department’s nonemergency line. He walked down the block to buy a bottle of water and, surprised at how quickly the first officer arrived, jogged to meet her in front of the house.

Kathrine Holder had been with the force for seven years. When Hodge explained the situation, she said she wasn’t too familiar with 5150s and called a superior. Sgt. Kimberly Reynolds, a veteran of 17 years, soon joined them. Hodge briefed her as well and the three entered the house.

The officers knocked on Teresa’s door, identified themselves as police, and entered her room. According to the officers, Teresa leapt from her bed. (Teresa later said she opened the door herself.) She screamed that they had no right, that they had no search warrant, and that she had a knife.

She grabbed it: It was serrated, with a six-inch fixed blade. Her family say she used to cut fruit in her room because she didn’t like using the communal kitchen. Teresa later said she’d eaten that morning. She managed to get the door closed. Holder radioed for backup.

Teresa later explained her actions in a deposition: “I didn’t want to be detained and hospitalized on the fact that I wasn’t in my right mind. Because I was. I was functioning [in] life well enough, and I didn’t want them disturbing me and hospitaliz[ing] me at a cost to the taxpayers and cost to myself.”

Reynolds thrust her torso against Teresa’s door, attempting to break it down, and ordered Holder to take out her pepper spray. She was unable to get the door down, so Holder, who was larger, volunteered to do it, and Reynolds held the pepper spray instead. They heard sirens. Reynolds then told Hodge to go downstairs to let the backup officers in. When the door finally broke in, they found Teresa still standing, still screaming threats, still holding the knife.

Reynolds pepper-sprayed her but it didn’t do anything, perhaps because of Teresa’s thick glasses. Then, because she felt cornered and feared for her life, Holder discharged her firearm, “two or three times.” She aimed at Teresa’s torso. When asked how much time had passed between the door opening and her first shot, Officer Holder later said, “I would be shocked if it was over five seconds.”

Still, Teresa did not drop her knife, and Reynolds fired her gun several times as well: first at Teresa’s torso, and finally a shot into her temple. Reynolds recalled Teresa was still standing when she shot her in the head; Holder said Teresa had fallen on the ground. Teresa’s eventual civil suit against the officers calls this final shot an “attempted execution.”

Teresa was transported to the emergency room. There were 14 bullet holes in her body. She had to have two hip surgeries. Her family say they didn’t know anything about the extent of her injuries until they finally saw her the next day. They just remember a doctor telling them that each of those bullets should have killed her. They remember that he called her survival a miracle.

“Woman Shot After Brandishing Knife,” read the story two days later in the San Francisco Chronicle. It described the threat against Hodge and said he was a social worker. It mentioned the threats against the officers. It included the word “knife” four times. It made no mention of the fact that Teresa Sheehan had a mental illness, or that she was having a psychiatric emergency, or that that was why police had been called.

After being held about a week, Teresa Sheehan, who had no prior criminal record, was charged with five felonies: making “terrorist threats” against Hodge and two counts apiece of assault with a deadly weapon and assault of officers of the peace.

Here is the question, the question that, despite seven years of litigation that have followed, has not been answered: Did the officers do the right thing?

Behind a closed door, did Teresa Sheehan pose a threat to herself or others, one that necessitated police interference? Or did the police, knowing that she was in the throes of a psychiatric crisis, and therefore irrational, paranoid, and potentially violent, have an obligation to accommodate that disability — by standing down, by calling for help, by buying time?

It’s a question with tremendous stakes. The systematic defunding of America’s mental health care infrastructure over the last half century and shifts in law surrounding involuntary treatment have produced an epidemic of people with severe mental illness who are unwilling to receive care and/or unable to access it. They’ve instead become vulnerable to untold, numerous horrors. They’ve filled the streets. They’ve filled emergency rooms. They’ve filled prisons. And if the prison has become the psychiatric hospital, the police officer has become the psychiatric nurse. This benefits no one involved: not individual officers, nor their departments, nor the taxpayers who pay for their mistakes. And it certainly doesn’t benefit the likes of Teresa Sheehan, nor her sister Patricia, who came home to a red light on her answering machine that night.

Government agencies do not reliably track the number of Americans killed by police. They do an even worse job of keeping track of what percentage of those have a psychiatric disability. A 2013 estimate by an advocacy group and the National Sheriffs’ Association guessed that the figure is at least half. A recent Washington Post report found that of the 462 people who have been shot to death so far this calendar year by police, 124, or about a quarter, were “in the throes of mental or emotional crisis.” Looking at California specifically, a BuzzFeed News examination of all people killed by police there in 2014 found that approximately 16% had a confirmed history of mental illness.

The large variation in these numbers may be due to differences in methodologies, as well as data being extremely difficult to obtain. In addition to no or poor department tracking and patient privacy laws standing in the way is the fact that people with severe mental illness often have compounding problems like drug addiction, poverty, and poor physical health. Many have also often lost all meaningful connections to friends or families. Many of those friends or families may have no interest in discussing these matters for any number of reasons. Regardless of the exact number: It is way too high.

Horrific stories about police killing people with mental illness are all too easy to find.

When Teresa Sheehan’s case reached the Supreme Court this spring, there was no clear consensus among the justices as to what the police officers should have done when faced with that closed door. On a legal technicality, they declined to rule in this matter and kicked the case back down to the lower, district court — which means the Sheehans’ lawsuit against the city and county of San Francisco may finally get a jury trial.

But as Justice Sonia Sotomayor said when this case was argued, the question of what should be done about people with mental illnesses as it applies to their interactions with police — and, one could argue, generally — is one we can no longer stand to not address. That is, she said, “Unless we want a society in which the mentally ill are automatically killed.”

Read the rest of this investigative report, originally published by BuzzFeed, here.