Air-Marshal kills bipolar patient in Miami

[PatrickBateman]

From what I've recently read about the situation, the person who was killed never said the the word "bomb". The passengers who were on the airplane confirm this. If this were true, I stand behind my statement.

http://www.orlandosentinel.com/news...dec09,0,3421926.story?coll=orl-home-headlines
psychedoc2b

Thanks. I suspected that when I read the story first. It seems more likely that the guy was just panicking, especially when we consider the snippests of conversation between him and his wife as mentioned above. I don't doubt that the marshall felt that the man was a danger and I support his action. It's all easier to unravel with a bit of 20/20. But my instinct as someone who used to work in the news industry was that there was a bit of official embellishment going on here. It's not in any way unusual, folks.

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[ORBITAL BEBOP]

Why cant the marshall use a stun gun or something that will incapacitate the victim without killing them!

Also, do manic bipolar patients usually present as claustrophobic? The presentation seems odd.

FZISHN

 

[Solideliquid]

Why cant the marshall use a stun gun or something that will incapacitate the victim without killing them!

Also, do manic bipolar patients usually present as claustrophobic? The presentation seems odd.

FZISHN

Thats what I have been thinking. I was supposing he was psychotic, its not uncommon for people with MDD or Bipolar to have associated psychotic symptoms. The ambiguity that plagues patient Dx really bothers me.

PS. I loved Gattaca.

 

[Anasazi23]

For what it's worth from Newsday.com:

Experts: Actions fit bipolar pattern
A Maitland man was acting like someone having a psychotic break, they say.

April Hunt
Sentinel Staff Writer

December 9, 2005


To the untrained eye, Rigoberto Alpizar simply was out of control when federal air marshals shot him at the Miami airport this week.

Psychiatrists, however, said reports of a 44-year-old Maitland man's erratic actions were textbook behavior for someone who suffered a psychotic break during a high, or manic part, of a bipolar episode.

"When you're manic, you think you're invincible," said Dr. Steven Speiser, a psychiatrist and medical director at Park Place Behavioral Health in Kissimmee. "You can become so out of touch with reality that when the police or FBI pull their guns on you and tell you to stop, it doesn't register."

Bipolar disorder used to be called manic-depression, for the dramatic mood swings experienced by those who have it.

A chemical imbalance in the brain can cause people to swing from deep depression to a manic state that can be plagued by delusions or psychosis.

In both extremes, those feelings become the patient's reality, doctors and mental-health advocates said.

Yet like other medical woes, such as diabetes, bipolar disorder has become something manageable with medication. Mood stabilizers, from lithium to seizure drugs, have helped those with the disease to live normal lives.

At one point during the Miami incident, Alpizar's wife, Anne Buechner, reportedly was apologizing for his wild behavior by saying he was mentally ill and had not had his medicine.

Buechner later told Miami-Dade police that her husband had been diagnosed with bipolar disorder, according to police reports.

It could have taken one day without medicine for Alpizar to deteriorate into a manic state in which he felt an inflated sense of self, said Dr. Jesse Tan, a psychiatrist and medical director of Lakeside Alternatives, a mental-health center in Orange County.

But the stress of traveling -- which disrupted his normal daily rhythm -- and having to wait in airport lines could have made things worse.

"If the patient had paranoia before, seeing security and lines would trigger that and head up the whole psychosis," Tan said. "This is conjecture, but he may think he was saving people from terrorism. But he did not see the severity of the situation."

Those with bipolar disorder are often the last to know something is wrong, as Rebecca Hobbs knows firsthand.

The Orlando woman was diagnosed with the disorder more than 20 years ago, after a friend had her involuntarily committed for psychiatric evaluation. At the time, she was feeling her highs for months at a time.

"I was spending money like I was a millionaire. I couldn't sleep. I was starting projects and could not stop," Hobbs said. "You feel great until you drop. The mania can be devastating."

Regular medicine has taken the edge off the mood swings when they come.

Hobbs now works with the Mental Health Association of Central Florida and thinks more people need to be aware of the symptoms of mental illnesses.

"I felt very sad for [Alpizar], mostly because he was in a mania when all this occurred, and no one was able to recognize it," Hobbs said.

In fact, even trained experts sometimes miss bipolar disorder, doctors said. Three-quarters of the 1 percent of Americans who get a diagnosis appear only as depressed, Tan said.

Rigorous questioning is needed to see whether patients ever have mania, which they may recognize only as feeling good, doctors said.

"I don't know anyone who thinks these air marshals did the wrong thing," Speiser said. "It's a very manageable disease, but can it be very unpredictable without treatment."

 

[MJD503]

A stun gun? Heck no, stun guns have no effect on a good portion of people...especially someone in a highly manic state. In this situation, Air Marshalls had two options (in their minds and training): Shoot this man dead or let 100+ others potentially die. What would you do? Besides, one has to figure a terrorist is probably in a different state of mind before an attack regardless of any diagnosable mental illness.

It is a sad story, though one has to see a bright side in this situation has only happened once. Shocking to me due to various factors previously mentioned here.

Police and law enforcement folks, in my experience, do a good job in recognizing MI and treating it as such, as much as possible anyway. I have seen it in my community. There has also been many horrible situations recently here in Portland, OR. A man approached two officers with a handheld weapon/knife, screaming and such, known mentally ill transient and the police shot him multiple times. In addition, a young man was recently in a car accident in the mountains outside of Portland, he suffered a head injury and resulting psychotic behavior. He jumped onto a cop car while naked, screaming and such but showing no physical aggression towards to the officers so when the cops tasered and pepper sprayed him without result, they shot him dead.

Debate is a great thing but you cannot fault the Air Marshalls. What happens if next time, in a similar circumstance except with a real bomb involved, one of these Marshalls doubts the seriousness of a threat and hundreds end up dead? Point being, these guys are not trained to think, per say, only eradicate problems safely and ASAP.

 

[Poety]

Also, when any peace officer is faced with a psychotic break - there is no telling what that person would actually do either - I think they tend to err on the side of their safety since in reality - what are they supposed to do? Say "Oh they're mentally ill, that's why they're doing it, so don't shoot to kill even though hes going to kill me?"

I've had patients on PCP - and let me tell you, they aren't stopping unless you have 5 guys restraining them. In a psychotic (although substance induced) I can see where they may get hurt - unfortunately for those that protect society - they have to live with these consequences and the backlash while we as physicians don't.

 

[psychedoc2b]

Questions Raised: Are Air Marshals Prepared to Handle Mentally Ill Passengers?
DOUGLAS E. BEEMAN, PAUL HERRERA AND MICHAEL FISHER
The Press Enterprise

The death of a bipolar airline passenger at the hands of federal air marshals has raised questions about whether the people charged with preventing violence in the skies are adequately trained to handle mentally ill passengers.
Several experts on mental illness and police training said they did not fault air marshals for fatally shooting Rigoberto Alpizar at Miami International Airport. But they suggested the Federal Air Marshal Service should re-examine how it trains marshals to deal with people who act erratically or irrationally due to mental illness or other brain disorders, such as Alzheimer's disease.
"This guy was mentally disturbed; he wasn't a terrorist, and he didn't have a bomb and the air marshals took him down, which is what they are trained to do," said Andrew Thomas, an aviation analyst at the University of Akron in Ohio.
"As it is right now, if an air marshal sees something that he perceives to be a threat to the aircraft, be it a hijacking or a potential explosive, the response is to shoot first and ask questions later," said Thomas, author of two books on aviation security.
Alpizar and his wife had just boarded an American Airlines flight from Miami to Orlando on Wednesday when he bolted from the plane with his arms flailing. Chasing him was his screaming wife - and a federal air marshal.
Witnesses said the man's wife frantically tried to explain that he was mentally ill and had not taken his medication.
Alpizar was shot moments later on a jetway after he apparently reached for his backpack, authorities said. Two air marshals were on the flight, and both fired at Alpizar, federal officials said.
The White House said Thursday that the air marshals appeared to have acted properly when they killed Alpizar, who claimed to have a bomb in his backpack.
Some passengers at Ontario International Airport on Thursday said they supported the air marshals' handling of the incident.
Some faulted Alpizar's wife for not calming him down. They said she should have made sure he took his medication before going into a tense situation like an airplane trip.
If a person's outbursts can't be controlled, that person should avoid mass transit, said Marilyn Rohr, 57, of Bangor, Maine. Rohr said delays caused by the Miami shooting were partly responsible for her spending two days in limbo while traveling between Boston and Ontario.
Another air passenger, Tim Whitacre, said air marshals couldn't be expected to know Alpizar was in the midst of a psychiatric crisis.
"It's not like he had `I'm bipolar and didn't take my medication' tattooed on his forehead," said Whitacre, 25, of Frankford, Mo.
Dave Adams, an air marshals spokesman, said the officers receive some training in dealing with "abnormal behavior." However, when they feel their lives are threatened, they react to forcibly take control, Adams said.
But several mental health experts said law enforcement officers can use other tactics for identifying and dealing with people who are mentally ill - but they need to be trained.
Risdon Slate, a criminology professor at Florida Southern College in Lakeland, said police officers are used to commanding respect and taking charge of a situation. Someone suffering from a mental illness might not react well to that approach.
"It may not be because someone's trying to be a jerk but maybe because the person's mentally ill," said Slate, who earned his doctorate at what is now Claremont Graduate University in Claremont.
Slate has trained police officers in how to calm someone suffering from a psychiatric crisis. Slate has an unusual perspective on the issue: Like the man killed in Miami, Slate is bipolar. He once was jailed after suffering a psychiatric crisis.
Slate said he doesn't know what kind of training air marshals received in alternatives for dealing with passengers with a mental illness or brain disorder, or whether they had any alternatives other than their handguns.
In some circumstances, a less-lethal stun-gun or bean-bag gun might be preferable to using a firearm, Slate said, although he did not know whether the marshals had access to such equipment.
Whatever their training, Slate said he hopes the federal government re-examines how it prepares air marshals to handle people with mental disorders.
"Unfortunately . . . crisis drives policy," he said.
Inland law enforcement officials say they train new officers in handling mentally ill people along with the other police-academy courses in firearms, use of force and search and seizure.
STRANGE BEHAVIOR
There are about 30,000 flights per day into and around the United States, Thomas said. Anywhere from 5 percent to 7 percent of the daily flights across the nation are carrying air marshals, and most of those are international flights, he said.
"If you fly from Ontario to Cleveland, it's more likely you are not going to have an air marshal on the plane, because its not a high-risk flight," Thomas said.
Most details about the Federal Air Marshal Service are closely held. The group has forbidden its members to speak publicly about their jobs and reveals only basic and generally vague information about their methods and training.
Adams said air marshals get two courses on dealing with passengers who act strangely. The first comes during a seven-week program at the Federal Law Enforcement Training Center in Artesia, N.M. That program is a basic law enforcement session. They get more specific training on unruly passengers later at a training center in Atlantic City, N.J.
Adams said the training deals with strange behavior, but when strange behavior takes a more threatening posture, lethal force quickly becomes an option.
The air marshals date back 30 years to the sky marshal program created to deter hijackings of flights to Cuba.
When terrorists hijacked four planes on 9/11, fewer than 50 marshals were available to guard flights each day.
In November 2001, the newly formed Transportation Security Administration was given 10 months to expand the air-marshal program from a few dozen to several thousand.
According to the General Accountability Office, the investigative arm of Congress, the rapid ramp-up led to shortcuts on training and security clearances. Air marshal training, designed as a 14-week program, was cut to five weeks for candidates with no law enforcement experience. Others had just one week.
In recent years, the Federal Air Marshal Service has sent active officers back for training on some of the skills that were skipped initially.
POTENTIAL FOR CONFLICT
Thomas, the air security author, said that without more information about Wednesday's shooting, it was hard to say whether the Miami air marshals acted appropriately.
Thomas said he expects the number of onboard confrontations between troublesome passengers and air marshals to increase, especially after a planned Dec. 22 relaxation of rules that prohibit air travelers from bringing some types of short-bladed scissors and tools on board airliners.
"If we don't upgrade the training of flight attendants and air marshals to be prepared to be deal with these permitted items, situations like (Wednesday's) will become more frequent," he said.
Adding to the potential for conflict is the rising incidence of air rage and increasing frustration among air passengers, he said.
Data show a direct relationship between the number of onboard disturbances involving passengers and the number of complaints air travelers lodge with the federal Department of Transportation, he said. In recent months, complaints jumped 30 percent as travelers griped about overbooked flights, delays and long waits tied to security, Thomas said.
Huntington Beach firearms instructor Greg Block, whose firm trains law-enforcement agencies, said air marshals lack some of the tools and resources police on the ground can utilize.
Police officers can use their uniformed presence, verbal commands, and other tools such as batons and pepper spray to try to control a situation. They also can call for backup, an option obviously not available to marshals once they're airborne.
The other issue at play in Wednesday's shooting - the plight of the mentally ill - puts attention on what one expert called a poorly funded mental health system that increasingly leaves people untreated.
About 2 percent of the population has a severe mental illness, but about 40 percent of those people are not getting treated, said Mary Zdanowicz, executive director of the Treatment Advocacy Center in Virginia.
Many states do not allow mentally ill people to be hospitalized involuntarily unless they risk harming themselves or others, she said.
"By law, you're letting people get on planes with severe mental illness," she said.
* * *
Staff writers Lisa O'Neill Hill and Naomi Kresge, and The Associated Press, contributed to this report.
* * *

 

[psychedoc2b]

MENTAL ILLNESS
Californians who may have a diagnosable mental illness: ONE IN 5
Number who may have a serious mental illness: ONE IN 15
In California, emergency calls to sheriff offices related to a mental illness crisis: 9 PERCENT
Nationally, people with mental illness are FOUR TIMES more likely than the general public to be killed by police in justifiable homicides.
Police are more likely to be killed by a person with a mental illness than by someone with a prior arrest for assaulting police or resisting arrest.
SOURCE: CALIFORNIA LEGISLATIVE ANALYST, TREATMENT ADVOCACY CENTER
* * *
COMPARING THE TRAINING REGIMENS
CALIFORNIA PEACE OFFICERS
BASIC TRAINING: A minimum of 664 hours in a police academy required, although most police academies in the state offer between 900 and 1,000 hours of instruction.
CURRICULUM: Officers learn how to use firearms, study criminal search-and-seizure laws, and learn basic police work.
SPECIALIZED TRAINING: After academy graduation, officers are partnered with field-training officers for at least 10 weeks.
- - -
AIR MARSHALS
BASIC TRAINING: Fourteen-week program. Candidates spend first seven weeks at a training center in Artesia, N.M.
CURRICULUM: Basic law-enforcement skills.
SPECIALIZED TRAINING: Candidates spend seven weeks at a training center in New Jersey, where they learn such skills as how to work in the confined space of a passenger cabin. Also, must pass an advanced marksmanship course and spend one week training with an airline.

 

[psychedoc2b]

Rigoberto Alpizar
by Charley Reese
by Charley Reese

Rigoberto Alpizar, a gentle Christian man with a loving family and a lot of friends, did not deserve to be shot to death by two federal goons in a jetway at Miami International Airport.
What is the duty of air marshals? It is to prevent terrorists from taking over an airplane. How can a man who is unarmed and not even on the airplane take it over? Alpizar, who suffered from manic-depression, got into a panic while returning from a missionary trip to Ecuador. He got up from his seat and bolted for the door, went out it and was running down the jetway toward the terminal.
This occurred shortly after he boarded the plane, which was still sitting on the tarmac with the jetway connected to it.
His wife, who was running after him and telling the passengers he was sick, was stopped and forced into a seat. The two air marshals, who for no known reason decided to pursue him, followed him into the jetway and shot him to death.
Their story is that he said something about a bomb and reached for his backpack. I say that is bull, a story they concocted to cover up a bad shoot. The passengers whose interviews I've seen said they didn't hear any talk of a bomb. Because he was not on the airplane, the Miami police are investigating, and I hope they do a thorough and transparent job of it.
There was no reason for the two undercover air marshals even to involve themselves. It is not a federal crime to want to get off an airplane. There was nothing in his behavior that would indicate he was anything but what he was, an ordinary passenger who wanted to get off the airplane. They should not have followed him off the airplane. They should not have shot him. And the gutless politicians and bureaucrats who rushed on television – long before they could possibly know any of the facts – to excuse the air marshals ought to be ashamed. It shows clearly where their loyalties lie – with the government, not with the people.
Air marshals should never reveal themselves unless someone is clearly about to endanger the plane or injure the crew or the passengers. They are undercover federal agents assigned to fight terrorists. They are not barroom bouncers.
An innocent American civilian (Alpizar was born in Costa Rica but years ago became a legal American citizen) died for no good reason. He lived in Maitland, Fla., and worked in a paint store. His wife said he had not taken his medication, which caused him to become agitated and desperate to get off the airplane.
I think the poor man was a victim of the boredom syndrome. Being an air marshal has to be the most boring and annoying job in the universe. Can you imagine having to fly on crowded airplanes day after day with nothing to do but watch passengers?
When Alpizar started running for the door, they roused themselves from their bored state and started to pursue him. They no doubt got angry because he refused their shouted orders to stop (if a guy had a bomb but was running for the door, why would you want him to stop?). When he did stop and turned to face them, one or both of them fired, and then I think they realized they had better think of a good excuse. They were lucky there were no eyewitnesses in the jetway.
They will probably get off, and we will have yet one more example of federal arrogance and disregard not only for people's rights but also for their lives. Personally, I'd rather take my chances with the passengers overcoming a terrorist than ride on an airplane with trigger-happy federal goons bored out of their minds. The federal government, by the way, has a poor record in hiring and recruiting these guys. They hired one guy only to later discover that he had been rejected by three police departments because of mental instability.
December 22, 2005
Charley Reese [send him mail] has been a journalist for 49 years.
© 2005 by King Features Syndicate, Inc.