The Overlap of Mental Health Crisis and Law Enforcement:

How Can First Responders Avert Tragedy?

By Susan Waller

“Everything can be fixed; just go with the flow,” Alex Domina.

Alex Domina was just shy of his 20th birthday when he was shot by a police officer called to tame a mental health crisis in a suburban Loveland neighborhood. Simply put, Alex, whose friends, and family say he was experiencing the best summer of his short life, suffered a mental breakdown on a warm August evening.

Judy Domina, his maternal grandmother, told Larimer County investigators that Alex had experienced a “sudden and unusual change in mood when asked to complete his daily chores.” Judy said she had not ever seen Alex have a violent outburst. She was unable to calm him after he threw furniture and destroyed household items that evening. Distraught, angry, and uncontrollable, Alex tried to kick out the glass from a sliding door. Afraid for his safety and the safety of family members and neighbors, Judy called 9-1-1 for assistance. A second call for assistance was placed by a neighbor, who remained in his yard, speaking with Alex, trying to pacify him.

She explained to the dispatcher that Alex suffered from severe mental illness and said he’d been institutionalized for most of his life. She described him that evening as uncooperative, destroying her house, and she feared he would harm himself or others. Judy told the emergency dispatcher he would likely need to be committed to be stabilized. Judy later said that being locked up again was Alex’s worst fear, but she felt she had no other choice.

When Loveland Police Officer Eddie Luzon arrived at the Domina home, Judy told him that Alex was in the backyard and was brandishing a butcher knife with an eight-inch blade.

“He was rocking back and forth. Our neighbor was talking with him, he was beginning to settle down, and he had lowered the knife to his side.”

“Alex kept saying, ‘I’m not going back, I’m not going back,’ meaning to the hospital,” Judy said.

She urged the officer to talk with him, to try to de-escalate a very tense situation. Judy briefly explained Alex’s mental health issues to Luzon, who, she said, did not wait for a backup officer to begin to engage Alex.

Officer Luzon approached the wooden fence that led to the backyard, with Judy behind him. Judy’s partner Dale Steinbaugh was behind her, and Alex’s half-brother Zach stood under a tree, across the street, with one of the family dogs.

Luzon, a two-year veteran of the Loveland Police Department, told investigators that he had Crisis Intervention Training Certification (CIT) through a now-controversial law enforcement program designed to teach officers skills to de-escalate critical mental crises. He said he was “confident” in his ability to manage Alex and begin a dialogue. He felt he had to enter the backyard through the gate to be able to converse with Alex. The gate was five feet high, and the officer stood at five feet, five inches.

“Alex had lowered the knife,” Judy said. “But when he saw the officer, he became alarmed and scared. He had a fear of being taken away from our home and locked up.”

“The interaction from Officer Luzon’s entrance at the gate until he fired was approximately one minute and 13 seconds,” Gordon P. McLaughlin, Larimer County District Attorney

“In that time, Officer Luzon asked Mr. Domina to put the knife down three times, asked Mr. Domina to talk to him four times, and once Mr. Domina begins to walk toward him, Officer Luzon articulated some form of ‘stop’ or ‘don’t come near me’ six times. Alex continued to approach the officer,” McLaughlin wrote after the Eighth Judicial District CIRT investigative report released on September 10th. https://www.larimer.org/sites/default/files/uploads/2021/ loveland _ois_alex_domina_8-16-21_opinion_letter.pdf

Rather than dropping the knife and heeding the officer’s commands, Alex, who weighed 244 pounds, continued to walk toward him. Luzon fired four shots: three hit Alex, and one slammed through the master bedroom window of the home directly behind the Domina residence. Judy said those neighbors were “luckily not at home that evening.” It had been usual for Judy and her family, as well as the neighbors behind her home, to dine outside in those summer evenings.

Over the next twenty-two days, Alex underwent five surgeries; he never regained consciousness. He passed away on September 7, 2021, a month shy of his 20th birthday.

After investigating the shooting, Larimer County DA McLaughlin concluded “no criminal charges are appropriate for Officer Eddie Luzon or Alex Domina regarding their conduct.”

“He was a child in a young man’s body,” said Dale Steinbaugh

As an infant, Alex suffered damage to his frontal lobe from beatings and sexual abuse endured at the hands of a stepfather. As young children, Alex and his older brother Zach had contact visits with Judy. Even at an early age, it was apparent that Alex was deeply damaged. Judy said that between the ages of three to five years old, Alex attempted suicide at least three times.

 “One day, while we were waiting for the bus, he ran out in front of a semi-truck. I grabbed him and rolled into the grass with him.” He kept saying, “I wish you’d let me die.”

At that point, he entered a series of hospitalizations at mental health facilities and foster homes. Judy was not given access to him for ten years.

“He must have thought I’d abandoned him,” she says. “He still remembered our visits and the desserts, cookies, and ice cream I had given him when he was a little boy,” Judy recalled. She gave him the same treats when he visited; she later learned he was lactose intolerant.

“His half-brother Zach is three years older and, while he also suffers from frontal lobe damage, he was able to endure the violence and sexual assaults better than Alex,” Judy said. Both Zach and Alex had IQs of 63, which The American Psychiatric Association considers “mildly mentally retarded.”

Judy adopted Zach when he was six years old, but Alex required inpatient services. In addition to his low IQ, Alex had a fluctuating array of diagnoses, including Post-Traumatic Stress Disorder, Oppositional Defiance Disorder, and Bi-Polar Disorder. He was on a cocktail of daily medications, and Judy had warned the emergency dispatcher that August evening that Alex “was heavily medicated.”

Judy and Zach moved from Nebraska to Estes Park in 2015, and Zach received mental health services from SummitStone Health Partners. During this time, Zach worked at the Estes Valley Community Center. When Judy began the process to become Alex’s legal guardian, she realized she would need to be closer to a community that provided more services, so they moved to Loveland in early 2021.

As Alex neared the end of Medicaid services this past spring, he began to have extended visits with Judy, her partner Dale Steinbaugh, and his half-brother Zach at their Loveland home. In May, Alex left inpatient care in Nebraska to begin life in Loveland.

“He had no life skills,” Judy said. “If I hadn’t taken him, he would have probably ended up on the streets.” Alex could read, but he did not know the alphabet. Judy and Dale set up tables in the basement with a system of teaching letters and words. He did not understand the concept of money.

He had his own bedroom and shared a bath and a ‘man cave’ with Zach. He called Judy and Dale ‘Mom and Pops.’ Dale taught Alex how to shave and ride a bicycle. He fondly recalls Alex urging him to propose to Judy and made Dale rehearse his proposal.

“He decided we would role-play my proposal,” Dale said recently. “Alex played me, and I played Judy. Alex got down on one knee and proposed.”

 Alex lived in Loveland for a brief time, but he quickly assimilated into the community. He bonded with one of the family’s Golden Doodle dogs, Lonah, and walked her to a nearby park in the evenings. He was outgoing and assembled a neighborhood group of dog-walkers to meet for conversation every evening. When Lonah had a litter of nine puppies earlier this summer, Alex insisted each be given a name that began with the letter “A.” The puppies were in a pen, in the backyard, during the shooting.

Judy recalled the first time they left Alex home alone. “He’d never been alone, anywhere. We were gone for a brief time, and when we came home, Alex was sitting out back on the patio, smiling. He was just so happy, happy that we trusted him enough to be on his own.”

Alex attended the day program at Elderhaus in Loveland and volunteered in the Alzheimer’s unit at the facility. He was a member of the Crossroads Church of Loveland and volunteered in the church bookstore.

“He nurtured his Christian faith,” Judy said. “He loved giving Pastor Ryan a fist bump and encouragement after services."

“Alex and Zach cherished being together,” Judy and Dale wrote in a memorial flyer. “They loved watching movies, reading, walking their dogs, helping neighbors, and sneaking off to buy candy at the neighborhood convenience store.”

“He shot my brother, but he didn’t mean to,” Zach Domina.

Zach watched Officer Luzon enter the backyard that evening. He heard the shots. He saw the officer return to his vehicle and collapse his head onto the steering wheel.

Alex died on the same day the city of Loveland announced a $3 million settlement in the violent arrest and beating of a 73-year-old dementia patient Karen Garner. The woman had attempted to shoplift $14 of goods from a nearby Walmart when she was thrown to the ground by a Loveland police officer and suffered a broken arm and dislocated shoulder. Four officers involved in this incident have resigned. The irony is that, when confronted by Walmart personnel, Garner surrendered the goods, but Loveland police were called to arrest her.

These two events focused a bright spotlight on how Loveland Police officers handle citizens in the throes of a mental health emergency. The Crisis Intervention Training Certification (CIT) Officer Luzon, referred to in investigative reports, is a nationwide law enforcement training program specifically developed to teach law enforcement personnel to manage critical encounters with mentally ill citizens. The program was developed in 1998 in Memphis, Tennessee, to provide a partnership between police departments, treatment providers, and mental health advocacy groups to manage crises involving mentally ill persons.

CIT training intends to give officers tools to reduce the risk of serious injuries or death during an emergency interaction and provide pre-arrest jail diversion for those experiencing a mental health crisis.

The forty-hour training program teaches officers how to recognize mental illness and provides knowledge about prescription drugs' psychopharmacology and their influence on mood, thinking, and behavior. There is also a component that provides information to officers about the mental health resources available in communities. Officers are taught how to de-escalate crisis situations and are given defensive weapons training. http://www.cit.memphis.edu/aboutCIT.php

This training has come under intense national scrutiny over the past several years, especially after the high-profile police killings of Eric Garner, George Floyd, and now, locally, with the death of Alex Domina.

According to a recent NPR investigation into the efficacy of CIT training, 25 percent of all people killed by police officers since 2015 “have had a known mental illness.” The report found that injuries caused by officers “are common although they are less carefully tracked. There's anecdotal evidence that botched encounters between police and people in a mental crisis are up during the pandemic.” https://www.npr.org/2020/09/18/913229469/mental-health-and-police-violence-how-crisis-intervention-teams-are-failing

A recent study found that people with untreated or undertreated mental illness are 16 times more likely to be killed during a police encounter than other civilians approached or stopped by law enforcement, according to the Treatment Advocacy Center in a report and urges an overhaul in the way law enforcement manages mentally ill people.

 “By dismantling the mental illness treatment system, we have turned mental health crisis from a medical issue into a police matter,” said John Snook, executive director of the Treatment Advocacy Center and co-author of the study.

“This is patently unfair, illogical, and is proving harmful both to the individual in desperate need of care and the officer who is forced to respond.”

The report, “Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters,” urges lawmakers to reduce loss of life and the many economic and social costs associated with police shootings by enacting public policies that will:

• Restore the mental health system so that individuals with severe mental illness are not left to deteriorate until their actions provoke a police response.

• Fund reliable federal tracking and reporting of all incidents involving the use of deadly force by law enforcement, whether lethal or not; and 

• Assure that the role of mental illness in fatal police shootings is identified and reported in government data collection.

Snook said the goal is to prevent those experiencing incidents from being arrested and help people get needed help, including support for caregivers. https://www.treatmentadvocacycenter.org/

Since 2016, SummitStone Health Partners, a Colorado-based mental health care and treatment operation has worked with the Larimer County Sheriff’s Office, the Loveland Police Department, and the Estes Park Police Department to provide services during mental health crises.

Cassie Damato, Acute Services Director for SummitStone, said they provide two levels of services with Larimer law enforcement agencies. In 2019, the Larimer County Sheriff’s Office and SummitStone partnered to form a Primary Response Mode, in which licensed mental health clinicians are paired with patrol deputies to respond directly to calls for service in the field. This is defined as a Mobile Crisis Response and is available day and night, every day of the year. They can provide hospital transport, and this helps cut down on emergency services costs for the county.

SummitStone clinicians typically respond to stabilized domestic violence cases and suicide threats, as well as illegal drug cases. Once a situation is soothed, their role is to mitigate trauma, develop support, and refer victims, family, and caregivers to additional resources. While the goal is to avoid arrest and jail, sometimes patients are transported by the clinicians to an in-patient setting.

Damato described the pairing of clinicians with law enforcement as a “really unique program” in which clinicians are dispatched either with law enforcement or after law enforcement has stabilized the scene. She said that every emergency call involving a crisis through Larimer Count dispatch is identified as a primary or secondary response.

A secondary response mode is employed with the Loveland and Estes Park Police Departments.

“At present, we have two trained clinicians embedded within the Loveland Police Department,” Damato explained. “As of now, until there is more funding, these clinicians provide services between 8 to 5 pm, weekdays, but additional funding and grant sources will bring in more money to expand these services.” Estes Park police has one clinician embedded, and he provides services on a part-time basis.

Even if Alex Domina had experienced his mental health crisis during weekday business hours, Damato said the clinicians would not have been permitted onto the scene until it was secured and safe for civilian entry.

Judy and Dale question Officer Luzon’s decision to enter the backyard that fateful evening. They wonder if Alex would still be alive if he remained behind the gate while attempting to de-escalate the situation.

“I wish sometimes I’d never made that call, but what if he’d bled out after kicking through the glass door? How would I have felt if he’d done that and died here?” Judy Domina

In concluding the report of the CIRT findings, DA McLaughlin stated:

“It is my sincere hope that this tragedy will spark deep thought and reflection from the Loveland Police Department and Loveland city leaders regarding how best to reform their current practices to better address calls for behavioral health crises, provide alternative means of emergency response, and strive to meet modern community expectations to reduce future harm and build trust with our fellow citizens.”

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