On the last day of her life, Stephanie Gerardi was spiraling. Once an aspiring contestant on “America’s Next Top Model,” on this day, her face was dirty, her manner erratic. Earlier, she’d been pacing barefoot in the street in front of her Saugus home, talking to herself.
Much of Gerardi’s adult life had been a battle with mental illness. When she was taking her medication for bipolar disorder with schizophrenic tendencies, she could still thrive, a loving mother to her two children, a smiling extrovert who could strike up a conversation with anyone. But when she stopped, as she often did, the results could be severe. Repeatedly through the years, her family was forced to have her involuntarily hospitalized.
On the afternoon of Aug. 14, 2021, Gerardi entered the hallway of the home she shared with her two sisters to find a pair of male police officers waiting. A third officer went to the back of the home, in case she tried to run.
The officers’ visit had been carefully orchestrated. Gerardi’s sister Stacey worried about Stephanie’s increasingly unbalanced behavior, had contacted Saugus police to begin the process of once again having her involuntarily committed to a psychiatric facility. She’d also taken Stephanie’s kids from the home, hoping to shield them from what figured to be a difficult scene. Another sister, Deanna, had remained at the home in order to be there when police arrived.
Initially, Stephanie seemed amused to see the officers. She asked to give one of them a hug, according to a report released later by the Essex district attorney’s office.
But when an officer told her not to touch him, her sister later said, something in Gerardi seemed to shift.
“Are you guys going to shoot me?” she asked, suddenly.
One of the officers, Sean Murphy, scoffed.
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Don’t be ridiculous, Murphy said, according to the DA’s report.
Moments later, he shot Gerardi after she grabbed a kitchen knife.
Death came in an instant. The shooting seemed incomprehensible to the sisters and beyond shocking, but it was not an outlier. Cases like Stephanie Gerardi’s often follow the same tragic script.
Replace the names or the towns, switch a few details. Otherwise, they are grimly similar: A relative or loved one dials 911 seeking help for someone in the throes of a mental health crisis. Police arrive. And something about the police officers’ very presence escalates a tense situation into something deadly.
In February, the relative of an Easton woman, Marianne Griffiths, who was grieving the recent death of her son called police because they feared she would hurt herself. Police shot her to death when she allegedly pointed a rifle-style BB gun at the officers.
A month earlier, Cambridge police shot and killed a 20-year-old UMass Boston student after a 911 caller reported that he was harming himself. Police said Sayed Faisal rushed them with a knife.
Last year, Paul Courtemanche of Burlington called 911 to report he was experiencing “mental health issues” and had a knife. Courtemanche stayed on the phone with police, but when two officers arrived at his apartment building, they fatally shot him after he allegedly ran toward them holding a knife.
A Globe analysis of police confrontations since 2016 shows that the majority of those shot by police in Massachusetts — 51 out of 88 — were people in the throes of a mental health crisis or who had been diagnosed with mental illness. That rate has risen significantly in the years since a 2016 Spotlight Team report, “The desperate and the dead,” on police shootings of people with mental illness.
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Far from defusing the crisis, the arrival of uniformed police often triggers an escalation, the Globe analysis shows, too often culminating in gunshots.
Nationally, there has been a growing push to rethink the response to mental health emergencies, one that has increasingly focused on complementing or replacing police with medics and mental health professionals. But Massachusetts police departments continue to primarily send armed officers with little back up from those best equipped to defuse these fraught encounters. A Globe review of more than 50 recent police shootings with firearms and tasers found that police here requested law enforcement negotiators or mental health professionals only six times.
The consequence? The death toll is rising. From 2016 to last year, police in Massachusetts annually killed an average of five people experiencing a mental health crisis, compared to three killings a year during the decade between 2005 and 2015.
The mental health crisis, of course, is everywhere. The pandemic left many Americans psychologically battered, sending mental illness numbers skyrocketing. The cases are often complex, intersecting with other societal issues including homelessness and substance abuse. And when the agitated person is armed or violent, there is no substitute for armed officers.
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But what’s also true is this: More and more frequently in recent years, police in Massachusetts have responded to mental health emergencies only to see them escalate, upon their arrival, into deadly showdowns.
“I don’t see anybody really taking any action on it,” said Dennis J. Galvin, president of the Massachusetts Association for Professional Law Enforcement, an organization that has focused on statewide police reform. “In Massachusetts, the problem is growing. It’s getting worse. So what’s the leadership doing? What are the elected leaders doing?
“Somebody’s got to use some common sense and try to come up with something.”
It’s not that police are predisposed to hurt people in the midst of a mental health crisis.
Officers are often working with incomplete — or incorrect — information. Sometimes these encounters play out over many hours as police seek a peaceful resolution. And even when the distressed person threatens them with a weapon, police don’t always shoot to kill; in the case of Faisal, an officer fired only after a nonlethal sponge round failed to slow him.
Sometimes, too, police are left with little choice. Two years ago, Boston police shot and killed Dashaun Wright in Dorchester after authorities said he shot and wounded three officers. Following Wright’s death, his mother told the Globe he had returned home from prison a few months earlier and had stopped taking his medication.
“They’re tough, tough calls,” said Mark Leahy, executive director for the Massachusetts Chiefs of Police Association and retired chief from the town of Northborough. “A lot of what we do is built on being able to reason with people. And if someone’s in a mental health crisis, they may lack the capacity to be reasonable.”
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But policing is an institution whose members are trained to respond in a way diametrically opposed to what mental health calls often require, experts say.
“[When] cops show up, they come to control the situation — by raising their voice and issuing commands,” said Jeff Coots, who serves as director of the From Punishment to Public Health initiative at the John Jay College of Criminal Justice in New York. “And when they roll into a party or a fight‚ that’s a good way to come in.
“In a mental health crisis, it’s the opposite of what we need.”
Most of the time, police don’t know what role mental illness is going to play when they respond to a call, but sometimes family members could scarcely be more clear: They call police to check on someone who is feeling suicidal or behaving erratically. Yet, the Globe review shows that, since 2016, nine people were fatally shot by police, another two died after being struck by a taser, and seven others were wounded by police gunfire when officers had been asked only to make sure the person was all right and got the help they needed. These are some of the cases that leave families especially baffled and bereft.
Miguel Estrella of Pittsfield had been drinking on the night of March 25, 2022, when his girlfriend, concerned that he was cutting himself, asked a friend to call 911 and ask them to perform a welfare check.
Estrella, 22, had a history of mental illness that dated back years, but it didn’t define him. He still battled suicidal thoughts — exacerbated, his sister says, by the 2019 death of a friend — but also worked for a time for Habitat For Humanity, according to his sister, and was studying to become an electrician.
On this night, however, his mood had taken a dark turn.
At one point, he used a box-cutter to slice his own cheek.
Police initially spoke with Estrella, but left after he declined medical attention. They returned after a friend of Estrella’s girlfriend called again in hopes of getting Estrella hospitalized.
This time, things quickly unraveled.
As police arrived the second time, they allegedly witnessed Estrella’s girlfriend trying to calm him. He was holding a knife, witnesses later said, and according to one witness told the officers to “stay away” and “leave me alone.” Officers initially attempted to tase him. But it seemed to have little effect except to make him angrier, according to the findings of an investigation by the Berkshire district attorney’s office.
Estrella’s girlfriend begged the officers not to shoot him, according to a witness. Police, too, pleaded with him to drop the knife.
“Don’t make me do this,” one officer told Estrella, according to a witness. “I don’t want to hurt you.”
But police and witnesses later said that Estrella moved toward them moments before police fired, fatally wounding Estrella as his girlfriend and witnesses looked on. The Berkshire DA’s office later concluded that the shooting was done in self-defense.
In the months since her brother’s death, Elina Estrella, has been besieged by what-ifs surrounding the events of that night. What if she would have been there to help calm Miguel? What if a clinician had been on-site to speak calmly to her brother?
Of this, however, she is certain.
“[If the police] didn’t show up,” she says, “he would be here.”
Stephanie Gerardi’s sisters still can’t believe police killed their often-lighthearted sibling. She was a woman, they said, who lived for her two young children, a fun-loving person who loved to get her nails done in a bright collection of colors and chat up the old-timers at a McDonald’s near her home.
But mental illness had been part of Gerardi’s life since her early 20s. Medication helped, the sisters say. But Gerardi fretted about the side effects, including the weight gain it brought on, and would stop taking it, repeatedly leading to worrying behavior and involuntary hospital stays. Sometimes, Gerardi tried to run out the back door when police arrived to take her away.
“She knew what we were doing for her,” said Deanna Gerardi. “She [eventually] came to the realization with herself that her family did love her and they’re basically doing this [to help]. But in the moment, that’s not what she’s thinking. She’s very angry in the moment.”
The sisters could always tell when Gerardi was beginning to spiral. Tidy and personable when she was taking her medication, she could become disorganized and manic when off it.
And on Aug. 14, 2021, Gerardi was clearly not herself.
That afternoon, Stacey Gerardi reached out to a friend who happened to be a Saugus police officer, explaining the situation. According to text messages reviewed by the Globe, he told Stacey Gerardi to inform police that Stephanie Gerardi was suicidal even though she was not, which Stacey did. The friend told Stacey that claiming her sister was a danger to herself or others would ensure a response.
In reality, Stephanie Gerardi was behaving strangely but posed a threat to no one, including herself, her sisters say.
Shortly after Stacey’s call, officers arrived at the home.
Police and family accounts differ on what happened next. Police said that after they entered the home and spoke briefly with Stephanie, Stephanie suddenly ran into the kitchen and picked up a knife, rushing at officers while holding it above her head. Sister Deanna Gerardi, who was in the home at the time, acknowledged that her sister had picked up a knife, but denied that Stephanie Gerardi threatened officers with it.
In the home’s cramped confines, Officer Sean Murphy fired his weapon three times, striking Stephanie twice in the torso and once in the head.
Less than an hour later, the officer with whom Stacey Gerardi had first been texting reached out again.
“What is going on [on] your street,” he asked in a text message. “I am hearing a shooting.”
“They shot my sister,” she responded, “she’s dead.”
Since the 2016 Spotlight series, Massachusetts law enforcement officials have made some strides toward improving their handling of mental health crises, particularly in the area of training. An increasing number of officers are enrolling in Crisis Intervention Team training programs that help them to better understand mental illness and to look for ways to deescalate crises.
And there’s some indication that officers more often actively seek a safe outcome in their encounters with those in crisis. The Globe review shows that, since 2016, police on 16 occasions have tried nonlethal methods such as bean-bag guns or tasers during encounters with people experiencing a mental health crisis. Two men died after being struck by a taser; eight were fatally shot; and six were wounded by gunfire, but survived.
And while police here have remained unlikely to call mental health professionals for help in the encounters that ended in shootings, it does happen.
When Newton police spotted a “rattled” Michael Conlon, armed with a knife, outside a candy story in January 2021, a social worker arrived soon after because she was a passenger in a police vehicle diverted to the scene. As Conlon placed the knife to his throat and threatened to throw a fire extinguisher at the officers, the police team grew to include an officer trained to deescalate confrontations, a department-employed social worker, and other officers who were armed with tasers and a shotgun equipped with nonfatal rounds.
None of it, however, made a difference.
The social worker, who was familiar with Conlon, was never asked by law enforcement to enter the building, and an attempt to use a bean-bag gun failed when the weapon malfunctioned, though officials couldn’t determine why, according to a judge’s inquest report. Police shot Conlon after he allegedly moved toward officers with a knife held at shoulder level, in what was later determined to be a justified shooting.
Conlon’s parents have filed a civil suit against the city of Newton and others in federal court. The city has asked a judge to dismiss the complaint. Conlon’s father said his son would still be alive if police had shown more patience.
“There was no imminent danger. None,” said Conlon’s father, Bob. “The only one who was in trouble was Mike.”
The bigger problem, some experts say, is that the response to mental health crises — in Massachusetts and beyond — still relies too heavily on police to act as the peacemakers when they are trained for something very different.
“I think it’s unrealistic that we can ask a hammer to be a corkscrew,” said Coots, of the John Jay College of Criminal Justice. “We can’t keep telling police, ‘In this one instance, behave differently.’”
That’s why cities and towns in other parts of the country have increasingly sought to remove police from the equation, sometimes altogether.
Since the 1980s, Eugene, Ore — a city of 175,000 that’s home to the University of Oregon — has relied upon a highly regarded mobile crisis intervention program called Crisis Assistance Helping Out On The Streets, or CAHOOTS. Instead of police, an unarmed two-person team made up of a medic and crisis worker responds to mental health and welfare check calls in the city.
More recently, the city of Denver launched what’s known as the Support Team Assisted Response, or STAR, program. Like the Eugene program, STAR seeks to remove police from mental health calls whenever possible. Emergency 911 dispatchers are trained to refer nonviolent incidents to a team of unarmed responders.
And the results, so far, have been promising.
A Stanford University study published last year found that the Denver pilot program dramatically reduced low-level crime, a development the researchers attributed to the fact that, without police on the scene, minor offenses such as trespassing and disorderly conduct — common in such incidents — didn’t result in arrests. The study’s researchers also noted a fiscal effect; the direct average cost of responding to each incident was $151 for the STAR team, they reported — a fraction of the estimated $646 average direct cost when police were involved.
But the most notable effect has been the ability of the civilian teams to help defuse situations and avoid violence.
STAR team responders were able to handle more than 4,700 calls in 2022 without involving police, according to a city spokeswoman. And since the program’s inception in 2020, the official added, none of the STAR calls has resulted in injury — either to staff or an individual being served.
“When you send unarmed individuals without a police presence, there’s a concern that the incident might escalate to something more serious — assault and battery or worse,” said Thomas Dee, who co-led the Stanford study. “And we found no evidence of that whatsoever. Over the six-month period of the [Denver] pilot period, they went on nearly 800 calls, and interestingly not one ended in an arrest.
“I think the lesson there is when these programs are well designed and well implemented, they work,” he said. “The [non-police] responders are not in over their heads in addressing these emergency calls.”
In Boston, a city that has regularly held itself up as a pillar of progressive policing, change has come in smaller steps.
A City of Boston spokeswoman said the city recently launched — or is expect to soon launch — new programs intended to treat mental health breakdowns as health issues, rather than criminal ones. Last October, the city instituted a system called TeleBEST that transfers mentally distressed callers to mental health professionals — more than 75 so far. The spokeswoman also said the city attempts to triage mental health calls and allow emergency medical services to respond independently if no crime is reported.
But the city declined to make anyone from those programs available for interviews.
The city’s handling of calls regarding people in the throes of a mental health crisis in recent years, meanwhile, has been decidedly mixed. Between 2016 and 2023, four of the 10 people fatally shot by Boston police had shown signs of mental illness, and police were injured during the fatal confrontations with three of the mentally ill men.
The city has also faced a pair of high-profile civil lawsuits stemming from the fatal shootings of two men in mental distress.
A wrongful death lawsuit filed in US District Court in Boston in 2020 by the family of Juston Root alleged police used excessive force when they killed the 41-year-old Root, who had a long history of mental illness. On the morning of Feb. 7, 2020, Root displayed a paintball gun at a Boston hospital, then led officers on a high-speed chase before he was fatally shot in a barrage of police gunfire in the parking lot of a Chestnut Hill shopping center. During the incident, a parking attendant was also shot in the face by a police bullet.
Though the civil suit — which accused the city and members of its police department of excessive force and negligent training and supervision — was dismissed in December, Root’s family appealed the decision.
The 2016 killing of Terrence Coleman has also drawn renewed scrutiny amid recent calls for greater police accountability.
In the early morning hours of Oct. 30, 2016, Coleman’s mother — worried that her 31-year-old son with a history of mental illness had been sitting outside in the cold all day — dialed 911 after speaking to her son’s therapist. On the phone with a dispatcher, the mother was clear: Her son was not violent, and she was concerned about how her son would respond if police were present.
Nevertheless, two officers arrived on the scene, along with a pair of EMTs who found Terrence Coleman sitting quietly on the floor of his bedroom. The EMTs went in first, and the encounter remained uneventful, a report from the Suffolk district attorney’s office later said, until Coleman apparently spotted a police vehicle parked outside the apartment. At that point, investigators allege, he grew increasingly agitated, speaking nonsensically before allegedly reaching into a plastic bag and producing a kitchen knife. Hope Coleman, who was present during the encounter, has denied that her son ever produced a knife.
After Coleman allegedly tried to attack one of the EMT workers, a pair of Boston police officers entered the apartment building and one fatally shot Coleman.
Coleman’s mother filed a federal lawsuit in 2018 against Boston police and the city, alleging the city failed to train police and emergency responders to assist people with mental illness, but the case has moved slowly through US District Court in Boston. In April, a federal judge ordered the city to pay Coleman’s legal team $94,000 after finding that the city failed to turn over documents and prepare witnesses to testify.
Nevertheless, the two officers present that night were eventually cleared of any wrongdoing following an investigation by the Suffolk district attorney’s office.
Both received medals of honor from the department for their actions during the incident.
Citing pending litigation, a spokesman for the Boston Police Department declined to comment on the two lawsuits.
It is a dreary and persistent pattern, but there are some signs of progress on the state level.
Last fall, the state’s police training organization updated police academy training to focus more on identifying and helping people in crisis. The training organization has also mandated training for veteran officers that includes deescalation and techniques for dealing with those suffering from mental illness. In addition, the state’s Department of Mental Health awarded more than $9 million in grants last year to be used for, among other things, co-response programs — in which clinicians pair with police to respond to behavioral health crises.
Last month, meanwhile, the uncle of George Floyd — whose murder by a Minneapolis police officer in 2020 sparked nationwide protests over police brutality — appeared in Massachusetts to champion legislation that would establish a statutory right to medical care during any police interaction where a person appears to be in medical crisis or says they’re in crisis.
The Medical Civil Rights Act, currently being considered in states across the US, would require police to immediately request emergency medical assistance for anyone who requests it during an interaction with law enforcement.
“We have some really good people across the state looking at this who are really looking at ways to chip away at the problem,” said Melissa Morabito, an associate professor in UMass Lowell’s School of Criminology and Justice Studies. “I think our understanding of the problem is fluid, so as we understand more, and as there’s more research and newer programs that are being implemented in other places ... we can learn from that.”
Yet, even as progress inches forward, tragedies have continued to add up. Just days after Floyd’s uncle appeared at the Massachusetts State House, police in Oxford shot a man who allegedly threatened an officer with a sword and appeared to be in the throes of a mental health crisis.
For those who have lost loved ones, however, any changes will have come far too late.
In Saugus, Stephanie Gerardi’s sisters are still trying to pick up the pieces following her death.
Nearly two years on, they do not have to look far for reminders of that day; they still live in the home where their sister was shot to death in the hallway.
The killing left Gerardi’s two children, ages 10 and 9, without a mother. The two are now in the custody of Stacey Gerardi, but she said they are confused, angry.
“It was an extremely tragic experience, but now watching her children grow up without their mom and what they’re dealing with in their school system has been very difficult,” said Stacey Gerardi.
“They miss their mom,” she said. “And they would’ve taken her any way that she was.”
Dugan Arnett can be reached at dugan.arnett@globe.com. Laura Crimaldi can be reached at laura.crimaldi@globe.com. Follow her @lauracrimaldi.