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Excessive Force in Involuntary Mental Health Examination

Eri Shoji and Catherine Burke
Journal of the American Academy of Psychiatry and the Law Online March 2025, 53 (1) 107-109; DOI: https://doi.org/10.29158/JAAPL.240125L2-24
Eri Shoji
Fellow in Forensic Psychiatry
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Catherine Burke
Assistant Professor of PsychiatryLaw and Psychiatry DivisionDepartment of PsychiatryYale University School of MedicineNew Haven, Connecticut
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  • Fourth Amendment
  • excessive force
  • involuntary evaluation
  • crisis intervention
  • crisis response

Fatal Shooting by Law Enforcement During Attempted Detainment of a Person with Mental Illness Is Not Always Unconstitutional

In Teel v. Lozada, 99 F.4th 1273 (11th Cir. 2024), the U.S. Court of Appeals for the Eleventh Circuit ruled on a case in which a deputy fatally shot Susan Teel while attempting to detain her for an involuntary mental health examination. The deputy was found not guilty at trial, and Mrs. Teel’s estate appealed several trial rulings.

Facts of the Case

In 2017, Mrs. Teel attempted suicide by cutting her wrists with a kitchen knife. Her husband, Dr. Dudley Teel, discovered her, and their daughter called the police. Deputy Lozada arrived at the scene to take her into custody for an involuntary mental examination. He entered the bedroom where Mrs. Teel was lying face up on the bed and ordered her to show him her hands. Mrs. Teel arose with a 13-inch kitchen knife, pointed it at Deputy Lozada, and told him to kill her. As she began to walk toward Deputy Lozada, he ordered her to stop. She kept approaching, and Deputy Lozada fired his first round. He retreated, but Mrs. Teel continued advancing. He fired three rounds, killing her.

In 2018, Dr. Dudley Teel sued Deputy Lozada and the sheriff of Indian River County on four counts. On count one, Dr. Teel sued Deputy Lozada for damages under 42 U.S.C. § 1983 (1996), alleging that the deputy had violated Mrs. Teel’s Fourth Amendment constitutional rights by using excessive force. Additionally, Dr. Teel claimed the sheriff was liable under Monell v. Dep’t. of Soc. Servs., 436 U.S. 658 (1978), for failing to train, discipline, and supervise Deputy Lozada. Counts three and four of wrongful death were dismissed voluntarily by the plaintiff.

In 2019, a summary judgment in favor of the defendants was granted. The district court ruled that Deputy Lozada did not use excessive force, thus invalidating Dr. Teel’s Monell claim. Dr. Teel appealed the summary judgment to the Court of Appeals for the Eleventh Circuit, which reversed in part and vacated in part. Following remand, the district court granted summary judgment in favor of the defendants on the Monell claim. The case proceeded to trial, and the jury found Deputy Lozada did not use excessive force in violation of the Fourth Amendment.

After the jury’s verdict, Dr. Teel again appealed to the Eleventh Circuit Court. First, he claimed that there were reversible errors in the jury instructions; second, he also claimed that Deputy Lozada’s prior violations of the county sheriff’s office policies should have been admitted as character evidence; and third, Dr. Teel argued that the district court should not have granted summary judgment on the Monell claim.

Ruling and Reasoning

After the case returned to the Eleventh Circuit, the court affirmed the district court’s second summary judgment decision, the ruling to exclude Deputy Lozada’s previous violations from evidence, and the jury instructions regarding excessive force. The court ruled that the jury instructions regarding involuntary examination were an error but opined that it was nonreversible because it did not prejudice the jury.

The alleged erroneous jury instructions referenced Graham v. Conner, 490 U.S. 386 (1989) with regard to the test for excessive force and the Baker Act (Fla. Stat. § 394.463(1) (2017)) as to involuntary examination. The jurors were instructed to determine whether Deputy Lozada utilized excessive force when attempting to detain Mrs. Teel. Because the Graham instruction was intended for lawful arrests surrounding criminal behavior, the instructions were modified to accommodate taking people with mental illness into custody. Dr. Teel argued that the district court erred by modifying instructions intended to measure excessive force in the context of criminal behavior because Mrs. Teel was attempting suicide, which is not a crime in Florida. The court of appeals concluded the instruction was appropriate, relying primarily on established case law, in which Graham was successfully applied to civil cases. It reasoned that the Graham test was flexible and the touchstone of the test was “reasonableness,” which weighs a person’s right to freedom against governmental interest, namely, excessive force.

The Baker Act, or Florida’s Mental Health Act, provides four criteria necessary for the involuntary examination of persons with mental illnesses. The proposed jury instruction included only one criterion, excluding others, notably informed refusal of a voluntary examination. Despite acknowledging this error, the appellate court ruled that it was not reversible because the error was not prejudicial, thus upholding the jury’s verdict.

The court similarly rejected the second argument regarding the evidence of Deputy Lozada’s history of misconduct. During 2016 to 2017, Deputy Lozada violated the county sheriff’s office policies seven times. This evidence was excluded before trial under Fed. R. Evid. 404(b)(1) (2017), as it was deemed improper character evidence. The appellate court did not accept Dr. Teel’s argument that the deputy’s intent in the shooting should also be considered, reasoning that the Graham test of excessive force was objective and irrelevant to intent.

The Monell doctrine, discussed in the third argument, established that a municipality may be liable for an officer when a person’s constitutional rights are violated. To impose liability, Dr. Teel was required to prove that the sheriff’s office had a policy or custom indicating deliberate indifference, namely, conscious or reckless disregard for the consequences of Deputy Lozada’s actions. Because the jury had concluded that Deputy Lozada did not use excessive force and therefore did not violate the Fourth Amendment with the shooting of Mrs. Teel, the appellate court affirmed the district court’s summary judgment.

Discussion

This case centers on the determination of what constitutes an “objectively reasonable” degree of force to detain an individual with a mental illness and the need for police training in crisis response. A study in 2018 indicated that approximately 25 percent of the civilians who were killed by the police exhibited signs of mental illness. Additionally, people with mental illness were more likely to be armed with a knife than a firearm, and the killing was likely to happen in their homes (Saleh AZ, Appelbaum PS, Liu X, et al. Deaths of people with mental illness during interactions with law enforcement. Int’l J L & Psychiatry. 2018 May–June; 58:110–6).

In recent years, initiatives have been developed to improve police interactions with people with mental illness. The Crisis Intervention Team (CIT) curriculum for police officers has been utilized with measurable positive effects. Although there is limited evidence of a reduction in shooting fatalities, officers have reported feeling less threatened and more prepared to successfully manage encounters with people with mental illness after completing CIT training (Hassell KD. The impact of crisis intervention team training for police. Int J Police Sci Manag. 2020; 22(2):159–70). Given these gains, researchers have urged community experts to assist with ongoing efforts (Lavoie JAA, Alvarez N, Kandil Y. Developing community co-designed scenario-based training for police mental health crisis response …J Police Crim Psychol. 2022; 37(3):587–601).

Munetz and Bonfine have opined in an American Medical Association Ethics Journal Viewpoint article that CIT program leadership must include psychiatrists throughout every programming stage, urging psychiatrist involvement in training officers, developing curriculum, guiding postcrisis intervention, consulting with officers, and helping CIT colleagues navigate traumatic experiences (Munetz MR, Bonfine N. Crisis intervention team program leadership must include psychiatrists. AMA J Ethics. 2022 Feb; 24(2):154–9). Although we cannot know whether the outcome would have differed if Deputy Lozada had undergone CIT training, other officers who have completed the training have demonstrated improved self-efficacy and improved de-escalation skills (Compton MT, Krishan S, Broussard B, et al. Modeling the effects of crisis intervention team (CIT) training for police officers… Int’l J L & Psychiatry. 2022 Jul–Aug; 83:101814). This has translated into lower rates of involuntary hospitalization and higher rates of voluntary treatment (Hassell KD. The impact of crisis intervention team training for police. Int J Police Sci Manag. 2020; 22(2):159–70).

Providing officers with the necessary tools to help manage mental health crises has proven to be a beneficial use of time and resources. This case highlights the need for crisis training for officers. It illuminates a growing need for psychiatrists to utilize their specialized skills to collaborate with officers and advocate for the populations they treat.

  • © 2025 American Academy of Psychiatry and the Law
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Journal of the American Academy of Psychiatry and the Law Online: 53 (1)
Journal of the American Academy of Psychiatry and the Law Online
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1 Mar 2025
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Excessive Force in Involuntary Mental Health Examination
Eri Shoji, Catherine Burke
Journal of the American Academy of Psychiatry and the Law Online Mar 2025, 53 (1) 107-109; DOI: 10.29158/JAAPL.240125L2-24

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Excessive Force in Involuntary Mental Health Examination
Eri Shoji, Catherine Burke
Journal of the American Academy of Psychiatry and the Law Online Mar 2025, 53 (1) 107-109; DOI: 10.29158/JAAPL.240125L2-24
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