Daniel Prude with Rochester Police Department officers (Photo by Associated Press)
My little brother is schizophrenic.
For a few years, when he was in his 20s, he was in and out of the hospital. When he became violent (he punched a hole in a plastered dining room wall) or threatened to hurt someone, my parents would telephone the police. One police officer went to Maria Regina High School with him. Other officers got to know him. Police often managed to talk him into the back of the police car before driving him to the hospital.
The New York State mental health system failed my brother, who is now 62, in many ways, but the Village of Hempstead Police Department always acted in a proper and upstanding manner.
Daniel Prude, who was also a mentally ill Black man, was not as fortunate as my brother. He died at age 41 in the custody of Rochester, New York, police officers.
A grand jury voted on February 23 not to indict any officers in the death of Prude, according to CNN (February 24).
“Daniel Prude was in the throes of a mental health crisis and what he needed was compassion, care and help from trained professionals. Tragically, he received none of those things,” said New York State Attorney General Letitia James in a statement later that day. “We concluded that there was sufficient evidence surrounding Mr. Prude’s death to warrant presenting the case to a grand jury, and we presented the most comprehensive case possible.
“While I know that the Prude family, the Rochester community, and communities across the country will rightfully be devastated and disappointed, we have to respect this decision.”
Last March 23, Prude’s brother, who worried that his visiting sibling might hurt himself, called the police twice within 24 hours. The first time, the Chicago resident was taken to Strong Memorial Hospital, where he left in an hour. The second time, it was predawn. Officers found him wandering naked on the streets of Rochester in a snowfall. They handcuffed him from behind, placed a “spit hood” over his head, and one officer used both hands to force Prude face down with the weight of his body for two minutes and 15 minutes and, then, with one hand for 45 seconds. Two other officers held down Prude’s torso and legs.
Prude, 41, was declared brain dead at the hospital. One week later, the father of five died and was taken off life support.
Mental illness frightens people, and many prefer to keep it at a distance. One neurosurgeon felt that way before the Prude tragedy. David A. Paul, M.D. learned of Prude’s death in an email: “Daniel Prude. Say His Name.” He learns more: Prude was in his city; he was at his hospital seeking care from his colleagues. Then, Prude becomes even closer to him. In The New England Journal of Medicine (December 10, 2020), Dr. Paul writes:
“His death hit me hard: another victim of police brutality, he was also a patient harmed by care decisions. As I learned more, my numbness turned to outrage. This man had been acutely psychotic after discharge from the emergency department; he had still needed medical care.
“Mental health conditions are ubiquitous, and it is critical to seek help for them. For Black people, however, help comes with substantial risk. One manifestation of this risk ended Daniel Prude’s life, but it does not have to end his story.
“Recalling that my great-grandmother was named Margaret Prude, I checked with relatives and discovered that Daniel and I were cousins. I found myself screaming inside, trying to find my voice as the world remained silent. Had I known this cousin was in Rochester, could I have advocated for him? Could I have persuaded my psychiatry colleagues to keep him in the hospital for monitoring? As I wondered, I was filled with guilt.
“I had never forgiven my grandfather for exposing me to the pain that comes with substance use and mental illness. Blaming him for his disease, I ran away from him – thereby missing an opportunity to meet Daniel at our last family reunion. The stigma of mental illness had deprived me of my heritage.”
The Monroe County Office of the Medical Examiner ruled Prude’s death a homicide, according to a copy of the autopsy report obtained by lawyers for his family. The report cited complications of asphyxia, acute PCP intoxication and excited delirium as causes of death.
“Deaths in police custody continue to be attributed to ‘excited delirium’, a condition that is not recognized by the American Psychiatric Association. Described as a stress response to overstimulation of dopamine and NMDA receptors, leading to cardiac arrest, it is used disproportionately to justify the deaths of Black and Brown victims of police brutality. But death by suffocation is not excited delirium.”
Dr. Paul writes that all Americans are responsible for his cousin’s death because the country has neglected to address both disparities in mental health care and police brutality.
“These incidents are not caused by a ‘few bad apples’: the problem is baked into every facet of our society. When 13% of our population but only 2% of psychiatrists and 3% of health service psychologists identify as Black or African American, there is a bigger problem.”
Paul adds that there is a scarcity of hospital psychiatric beds. The Treatment Advocacy Center recommends that 40 to 60 inpatient psychiatric beds for every 100,000 people, but New York State has only 16.3 beds for every 100,000.
“When an acutely psychotic patient cannot be admitted for lack of a bed, someone’s life is put at risk. And when physicians and nurses can’t see their brother, father, son, cousin, or nephew in a patient’s face, getting him appropriate care may be an uphill battle.”
He says that as a Black community, we can accept that mental illness is a disease, not a choice. This is the biggest step. Without that recognition, we cannot go on to encourage our children to pursue careers in mental health.
“I hope that one day my legacy will not be stained by helplessness in the face of mental illness – that one day, my son will be able to seek help if he needs it without being sentenced to death.”