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Saving lives behind the scenes: The pivotal role of threat assessment in crisis aversion

When a young man with harmful intentions is persuaded to seek help, a Behavioral Threat Assessment and Management team’s prompt intervention illustrates their essential function

Silhouette of troubled person head.

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When you select a career in law enforcement you are signing up for a career’s length worth of sacrifice. Sometimes the sacrifice is your physical self (the long hours, potential injuries, night shift), your psychological self (the trauma, the victims, the stress) your time (mandatory overtime, another call out) and your soul (moral injury).

On this particular day, the sacrifice to be made was the wonderous delusion that is Disneyland California. To suspend reality even for a moment can be a gift when you choose this profession. The phone call went something like this:

Sergent: “Hey doc, I got a case for you.”

To which I replied, “Copy that, Sarge. I’m at Disney with the kids, can it wait until tonight or tomorrow?”

The response was clear as I watched the Mickey Mouse ice cream sandwich melting all over my son’s stroller.

“Doc, this case can’t wait.”

Behavioral threat assessment cases rarely can when there is someone who intends on committing an act of targeted violence. They don’t care about my ice cream.

“Sarge, you have my full attention. I rearranged my schedule and I’ll be at the station by 0530 tomorrow morning.”

We have learned a lot since Columbine academically and experientially. Twenty-five years ago, terms like “leakage,” “grievance” and “pathway to violence” weren’t operationally defined within the threat assessment context. Twenty-five years ago ballistic backpacks didn’t exist and neither did school shooter safety drills. Some might say we’ve come a long way — but it is down a path no one wanted to go.

This is what we had:

A young man with suicidal ideation had been convinced by his friend to go to the emergency room to get help. During the initial psychiatric assessment, the subject shared he had been feeling depressed for some time and wasn’t seeing a future for himself. His suicide method was complex. He intended to carry out a “mass shooting” at a music festival — one that was about 2 weeks away and 40 miles north with a firearm he purchased 6 days earlier. He planned to attend the festival (he already had tickets and a parking pass) and shoot as many people as possible until law enforcement arrived when he was going to force suicide by cop.

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As we see with many persons who commit targeted violence, such as mass shootings, they are methodical and have contingency plans. Our subject expressed to the psychiatrist he had wanted to commit a mass shooting years earlier but was too depressed at the time to follow through. He mentioned that recently he had been practicing shooting himself in the head with an unloaded firearm so that if law enforcement failed to kill him during the event, he would have the muscle memory to kill himself. He had downloaded and listened to sound bites of kids screaming and sounds of gunshots and watched videos of suicides and executions. He was isolated and lived alone. His “friends” were “fake” and he hated women because he had never had a girlfriend. At this point, the psychiatrist called law enforcement to take a report.

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Generally speaking, when law enforcement receives a case like this, the first consideration is whether a crime has been committed. When clinicians receive a case like this, the first consideration is whether there are criteria for an involuntary psychiatric detainment.

In this case, we did not have a crime — the elements of criminal threats were not met — but we had enough probable cause for a psychiatric detainment. Suicidal intent, check. Homicidal intent, check. Even so, many variables can impact whether a subject can be detained. Is a bed available? Will a hospital accept him for treatment? Will he talk himself out of a hold when the next psychiatrist comes on shift? Will he walk out of the emergency room only to have the hospital call law enforcement and ask for them to bring him back?

In situations like these, relationships make all the difference. A relevant law enforcement adage comes to mind, “Don’t wait until you get to the command post to exchange business cards.” About a year before this incident, we had established a multidisciplinary behavioral threat assessment team (BTAM) within our county whose mission is to work on these types of cases. We utilize the training and experience brought forth by local and federal law enforcement, clinicians, school administrators, hospital psychiatrists, legal counsel and others and apply it toward assessing, managing and dispositioning cases.

Both the sergeant and psychiatrist had been to one of these meetings and had some basic understanding of BTAM. Someone without this training might look at the case and ask, “Why would the subject go to the hospital voluntarily and talk about his plan?” The conclusion might be “He can’t be serious if he’s talking about it, he just wants attention.” Then the case would be dismissed and forgotten about.

In the BTAM world, we call this subject’s actions leakage. Leakage is defined as the communication a subject makes to a third party about their intent to commit violence. The research shows this happens more often than not by people who have committed mass shootings. Over 50% of the time leakage of some kind (statements, drawings, social media posts, manifestos) is noted.

Case management: Coordinating across disciplines

After consulting with the players, the decision was made that our best chance of mitigating the threat was through the mental health system. The psychiatrist was very detailed in his petition for placement and our subject was placed in a locked mental health facility the next day.

The first major hurdle was successfully met. We bought ourselves some time.

Within the first 24 hours, we did the following:

  • I wrote a letter to the medical director of the hospital detailing my concerns as the police psychologist who consulted on the case.
  • The primary law enforcement agency went to the store where our subject purchased his firearm and stopped the sale. (When someone gets admitted to a licensed psychiatric facility in California there is a five-year gun ban is initiated.)
  • The law enforcement agency whose jurisdiction included the location of the festival informed the security team of the threat and assisted in the procurement of a restraining order.

One of the nurses working the floor of the inpatient unit was married to a police officer I’d worked with previously. When she saw my name on the letter to the hospital she obtained a release of information from the patient (our subject) so we could discuss the case. We spoke daily at first to ensure the rotating psychiatrists understood the problem and did not release our subject prematurely. Ultimately, the powers that be ensured he stayed at the institution through the end of the festival, for a total of 15 days.
In totality, we successfully mitigated the threat. Once the subject was released from the hospital, the primary law enforcement agency utilized their co-response teams to engage with our subject for a period offering services until the subject no longer answered the door. Where is he now? We don’t know. Does he continue to be suicidal or homicidal? We don’t know that either. What we do know is that it has been almost three years since this case was dispositioned and the carnage has not come to fruition.

Had it not been for the relationships cultivated through BTAM I might be writing a different article. That being said, I feel it’s important to mention that in law enforcement work you can do everything right and things still go wrong, and the BTAM world is no different. Non-criminal threats of targeted violence are on the rise.

We have learned a lot since Columbine about the mindset of mass attackers, the pathway to violence and best practices that can be deployed to mitigate the problem. As law enforcement and healthcare leaders, we must ensure frontline personnel are equipped with a fundamental understanding of these principles so they can at least raise their hand and pass the circumstances along to someone who can look at it through a BTAM lens.

And finally, you might be wondering about my own wellbeing since, after all, I never got to finish my Mickey Mouse ice cream sandwich. If we happen to run into each other at the Association of Threat Assessment Professionals Threat Management Conference (ATAP TMC) coming up this summer (coincidentally hosted at the Disneyland hotel), you’ll appreciate why I may hit the ice cream cart before the networking events begin.

NEXT: Dr. Jack Rozel on navigating the terrain of behavioral threat assessment management

Dr. Cherylynn Lee is a police psychologist and works full-time for the Santa Barbara Sheriff’s Office as the Behavioral Sciences Manager, overseeing the mental health co-response teams, CIT training and the internal Wellness Unit, including Peer Support. Dr. Lee is a member of the county’s threat management team and consults on threat assessment cases around the state. She also serves on the crisis negotiation response teams for both the Santa Barbara Sheriff’s Office and the Santa Barbara Police Department and teaches in the FBI 40-hour Crisis Negotiation Academy.

Dr. Lee has a private practice in the Santa Ynez Valley where she sees first responders exclusively, specializing in trauma, post-traumatic stress and mindfulness. She is contracted with The Counseling Team International to offer counseling and emergency response services across the state of California. Dr. Lee has led many critical incident stress debriefings for OIS, LODD, natural disasters and as requested by both local and state fire and law agencies.

Dr. Lee is also a subject-matter expert with CA POST on both officer and dispatcher wellness and has participated in several training videos and initiatives aimed at supporting and encouraging wellness for departments and their personnel. She currently sits on the California State Sheriffs Association Wellness board. She can be reached at