SALINAS >> Twenty-three years ago, a pregnant Andrea Boutelle was rushed into surgery when doctors discovered the umbilical cord had wrapped around her son’s neck in utero. By the time doctors removed the fetus, it was too late. The infant’s brain had been starved of oxygen and he was left with a traumatic brain injury. In June, that brain damage appears to have played a role in a violent confrontation with police.

Kole Lemon’s brain injury manifests itself with erratic behavior, including bouts of psychosis that have, at times, led to violent outbursts. It was such a psychotic break that resulted in Lemon’s arrest by Salinas Police officers, which in turn caused some to question whether or not police are properly trained to engage with individuals suffering a mental health crisis. A Monterey County civil grand jury report released in April asked that same question.But that doesn’t seem to be the case here. About 90% of Salinas officers have been trained by a crisis intervention team and the 10% who are not trained are currently scheduled to attend training. Three of the four officers who responded to the call involving Lemon were CIT-trained.

Communication breakdown?

The incident began when Lemon, as his mother describes it, “flipped a switch,” around noon on June 21 and began throwing furniture around inside their Salinas home. Boutelle said when she called 911 to request psychiatric assistance for her son, she specifically requested a 5150 hold, a California Welfare and Institutions code that allows for involuntary psychiatric hospitalization of an adult for up to 72 hours.

It would later come out in court that at least one of the responding officers was never informed that it was a 5150 request, only that a mother-son altercation had turned violent.

Police can only act on what they know, one of the responding officers said in a court hearing. What they understood was that there was a male adult violently throwing furniture around and was a possible threat to his mother and others.

An option available to police involving an individual experiencing a mental health crisis is to contact a Monterey County Behavioral Health team that is trained in de-escalating encounters. But in this case, with an individual experiencing a violent psychotic break, police needed to be concerned with the public as well as the safety of their officers, a police commander said.

A similar scenario played out on the evening of July 24 when four Salinas Police officers responded to the 200 block of Main Street for a homeless man showing signs of mental illness. Once determined the man was not a threat, the officers contacted Behavioral Health. While waiting for the mental health experts, the officers stood at a distance, continuing what sounded like a calm conversation.

When the two Behavioral Health experts arrived, one engaged the man while the other checked a database that, had there been an earlier encounter, the Behavioral Health team would know exactly what type of illness they were dealing with as well as past behaviors. The incident ended peacefully.

June 21

The official police version of what happened with Lemon on June 21 was disputed by Boutelle. Officers say he was walking toward Boutelle in a threatening manner. Boutelle said he was actually walking away. Having been determined by a judge that Lemon should stand trial on one count of resisting arrest, he and his mother’s version of events on that afternoon were played out for a second time in a courtroom.

The one thing that is not being disputed is the degree of Lemon’s behavior.

“It was the worst psychotic break I’ve ever seen,” his mother said. “He spoke to me like he was possessed; he was demon-like with pin-point eyes almost staring through me.”

Grand jury report

The issue of police engagement with those suffering a mental health crisis is nothing new. It has been examined across the country following tragedies for people in crisis as well as responding police officers. In Monterey County, the issue was investigated by a civil grand jury.

The civil grand jury issued a report that examined the training Sheriff’s deputies and Salinas police officers have had in response to individuals suffering mental health crises. The jury report noted that police responses can be more effective when one or more of the officers are trained in interactions with people experiencing a mental health crisis.

“It reduces escalation and the possible use of force, and in some cases costly litigation. In addition, Monterey County and many municipalities have Mobile Crisis Response Teams comprised of trained mental health professionals,” the report reads. “Sometimes these calls result in the hospitalization or incarceration of the individual, or in tragedy, either for the individual or the responding officer.”

There have been several tragedies involving police encounters with mentally ill individuals. In 2014 Salinas Police shot and killed a mentally ill man who was waving gardening shears at officers. And in 2019 Salinas Police fired 18 times on 20-year-old Brenda Rodriguez, who was wielding a replica gun inside her vehicle, killing her.

There was no way for police to tell whether the gun was a replica or not.

In body camera footage, Rodriguez showed signs of psychosis, including delusions, paranoia, hallucinating voices and depression, according to the Monterey County District Attorney’s Office.

Officers, too, have met with tragedy when encountering a person having a violent mental-health breakdown. According to an FBI report, eight of the 57 people who killed police officers in 2023 were reported to have a mental illness.

Responding to calls involving mental health crises is common. Studies suggest that 15% to 37% of police calls involve a mental health crisis, substance abuse issues or other situations where immediate intervention is needed, the grand jury reported. Specially trained officers who are part of or working with what’s commonly known as a crisis intervention team, or CIT, can be deployed when a 911 call indicates a mental health crisis.

While the grand jury report indicated that more training was needed in the department, acting Salinas Police Chief John Murray on June 11 responded that he agreed that there is no formal collaboration among mental health providers and police. He also agreed that, as the grand jury wrote, “a case-by-case response is not a consistent or effective strategy and does not serve the community well.”

He also noted, however, that 90% of his officers have had CIT training and the 10% that haven’t been are scheduled for an upcoming training.

Through Lemon’s eyes

By the time Lemon was 2 years old, it was clear he was suffering from numerous mental health challenges. A written copy of diagnoses from a 2019 evaluation by a Monterey psychiatrist was shared by Boutelle with The Herald. It listed five different mental health disorders. Boutelle has power of attorney over Lemon’s medical care.

Another evaluation when Lemon was just 3-years old foreshadowed the behavior he would manifest as an adult, as well as the physical challenges he would face. The report was an occupational therapy evaluation conducted on Lemon by New-Found Therapies in Monterey in 2004.

A paragraph on page 4 of the evaluation links Lemon’s behavior to his brain injury. A person with Lemon’s injury has “sensory processing dysfunction,” meaning the person is unable to organize what they need to do in an appropriate way.

“This may cause the individual to resort to the primitive survival techniques of fright, flight and fight located in the ‘primitive’ brain,” the evaluation reads. “This fright, flight and fight response can appear extreme and inappropriate for a particular situation. This causes the person to act instinctively rather than appropriately.”

Before the evaluation, Lemon was tested for several abilities — spatial recognition, reading body language, social interactions, and expectations. He did poorly on the test. Placed in the context of interacting with police and police commands, the conditions outlined in several evaluations could affect Lemon’s ability to act appropriately.

“He is impulsive, acts without fully thinking about the environment or the task, and he is easily distracted by noise and sound,” according to the report. “This may also affect his ability to develop teamwork skills, have the ability to manage conflict and have successful personal relationships.”

A day in court

On July 18, Lemon appeared in Monterey County courtroom handcuffed along with a half-dozen other jail inmates for his preliminary hearing. During a preliminary hearing in criminal court the judge considers whether there is enough evidence to hold the suspect over for trial.

When his case was called by Monterey County Judge Andrew Liu, Lemon a seat next to Rachel Scoma, his assigned attorney from the Monterey County Public Defender’s Office. He was charged with resisting arrest.

Lemon had a contusion around his right eye clearly visible from 50 feet away, the result, Boutelle said, of being jumped in jail while being housed with the general population. He sat passively but on occasion would bounce his feet up and down.

During the preliminary hearing, one of the responding police officers, Isaac Lopez, took the stand and recounted his version of events on the 21st. It began with what Lopez said was a dispatcher call-out of a dispute between mother and son.

Because the call was about a male throwing furniture around, police responded with the expectation that Lemon was violent. However, Boutelle insists that when police arrived, the furniture-throwing incident was over and Lemon was no longer violent.

The only conversation between police and Lemon was a command to stop, according to Lopez’s testimony.

Lopez testified that Lemon had moved aggressively toward his mother, which Boutelle denies. At that point, other officers began to arrive and Lopez and another officer each grabbed an arm of Lemon.

It was when Lemon spotted another officer’s Taser pointed at him that he panicked, Boutelle said.

“I had my hands up,” Lemon said in a telephone interview with the Herald from Monterey County Jail on July 19. “I have no idea why they grabbed my arms. They never tried to relax me.”

At that point Lemon began to struggle, according to police testimony. Boutelle said after the hearing that Lemon can become confused and panicked in situations like that. He has the cognitive ability of a fourth- or fifth-grader, she said.

At one point in the hearing, Scoma attempted to raise the issue of Lemon’s traumatic brain injury, but the prosecutor objected, claiming it was hearsay. It was sustained.

In her cross-examination of Officer Lopez, Scoma asked if he had heard any reference to a 5150 request in the call-out. He responded that he did not. The prosecutor said the police acted on the information they had at the time.

Later, police would say a couple of the officers knew him and had prior encounters, but, again, the only way to end the threat to others was to get him on the ground and handcuffed.

That left the felony resisting arrest charge. After wrestling Lemon to the ground, two officers had a hold on each of Lemon’s arms. A third officer climbed on Lemon’s back. Lopez testified that he heard Lemon’s heels striking the officer on the back of his vest — likely soft body armor.

But since Lemon was on his stomach, his actions were more like bending his knees back and forth than kicking, Scoma said.

Boutelle requested a copy of body cam footage of the arrest, but on Aug. 1 Colleen Reardon, the custodian of records for the Monterey County Emergency Communications Department, wrote to Boutelle that her request is being denied. Despite Lemon having already been charged, Reardon said there was still an ongoing investigation.

Judge Liu, while expressing some skepticism that Lemon was kicking the officer with intent to harm, nonetheless allowed the charge to stand. Lemon on Aug. 6 accepted a plea bargain where he pleaded guilty to the resisting arrest charge. The next court date is tentatively set for late September for sentencing.

Back at the scene of the struggle on June 21, Lemon was placed in the back of a police car where he began slamming his head against either the seat in front of him or the metal meshing separating the front seat from the back seat, causing a laceration on his head. His mother said blood was running down his face and was smearing blood on the car window.

Lemon was transported to Natividad Medical Center, Boutelle said. But he refused treatment for the laceration. There was no attempt at a psychiatric intervention, Boutelle said. Instead, he was taken to jail. Police Commander Brian Johnson said that 5150 holds are generally reserved for suicidal ideation. But because of the violent nature of the arrest, and no apparent suicide ideation, jail was the appropriate place to house Lemon

The arrest left him bruised on at least four places on his torso, based on photos provided by Boutelle. She vowed to “never again call the police when my son is in crisis.”

The question that lingers is would the outcome have been different if there was an attempt to de-escalate the incident, possibly by a person trained in mental health crisis management? That’s not likely because of the violence Lemon exhibited, said Johnson, the police commander.

“He was in a fit of rage,” he said. “There was no talking to him.”

Boutelle said Lemon only became outraged when police pointed a Taser at him and that there was no attempt to talk to him other than the command to stop.

Judge Liu said that this case is like many playing out across the country. There is a gap between dealing with mental health issues and the police. It puts the police in a difficult position, Liu said.

“There’s no easy solution,” he said.

In the meantime, Lemon remains jailed.

Salinas Police training

With up to a third of all police dispatches involving either the mentally ill, people under the influence of drugs, or both, these calls are some of the most dangerous for responding police because of the high level of volatility. It’s critical for responding officers to know what they are walking into they say.

Johnson conducts 40-hour CIT training for officers in the department. During a recent interview with the Herald, Johnson described how such classes are structured.

In the course, Johnson will describe to the officers any number of mental illnesses they may encounter — from autism to schizophrenia — and possible behaviors they would likely see. He brings in volunteers who are suffering from mental illnesses like schizophrenia to advise police on what to do and what not to when they encounter the mentally ill.

“If we understand these illnesses then the better prepared we are to help,” Johnson said.

In a coincidence, Boutelle is one of the speakers who is brought in to describe her son’s mental health issues.

Officers will watch videos of encounters with people suffering mental health breakdowns, both with positive outcomes and those that went south. Johnson cites statistics reflecting various situations so officers have a sound idea what the chances are of encountering any number of related scenarios.

On a typical 40-hour training, such as one coming up in October, a host of experts on various aspects of mental health will tackle a wide range of sessions. Most will be taught by Melanie Rhodes, the deputy director of Behavioral Health. Among her specialties is crisis management.

She and four colleagues are scheduled to open the session with a very common condition police officers see regularly — co-occurring disorder and homeless issues. Co-occurring disorder, sometimes called comorbidity or dual diagnosis, is when the person police encounter suffers from more than one illness at the same time. A classic example is depression compounded by drug addiction.

If the drug is methamphetamine or a similar type of drug, the individual can have abnormal strength, which is a danger to responding officers. Johnson related an incident where it took six officers to control an individual under the influence of drugs.

That topic will be followed by children’s issues, mood disorders and personality disorders. Among the spectrum of personality disorders is antisocial personality disorder, which was one of the diagnoses assigned to Lemon by the Monterey psychiatrist.

All of that is just the first day. The course continues for another four days.

The long view

Boutelle describes her son in between episodes as “sweet” and even “charming.” In his interview with the Herald from jail, he was soft-spoken, respectful and seemingly vulnerable. But there is that switch when turned on makes him extremely angry which can quickly turn to rage his mother says.

He has a record of six misdemeanors and one felony involving a stolen vehicle, most stemming from behavior problems that led to a criminal charge.

Lemon has resisted therapy and has a spotted history with medicines; at one time he overdosed on them. He doesn’t want to take medicines because of side effects he has suffered on them, including severe weight gain, allergic reactions, drooling and seizures in his eyes that caused some pain, Boutelle said.

Mental illness can also take a toll on loved ones. One recent study examined the effect on loved ones caring for a mentally ill adult child. Caregivers had higher levels of stress, depression, anxiety, sleep disturbances and work fatigue as well as lower quality of life, compared to caregivers of family members without mental illness, the study reported.

Boutelle has been caring for him for 23 years. She acknowledged that it can be exhausting and sometimes disheartening. Always a roller-coaster ride.

Options are limited based on what Boutelle is willing to do at this point, as well as what Lemon is willing to accept. The thought of Lemon living in some kind of institution is antithetical to her as a mother, she said. Boutelle said she wrestles with her options nearly every day.

“The mom side of me says that he will agree to actually participate in therapy and learn some skills and be able to live on his own,” she said. “The jaded side of me says he is just going to live with me for the rest of his life, and I will be doing this until the day I die.”

During the jail interview with the Herald, Lemon was on speakerphone. As the interview ended, Lemon told Boutelle he loved her. The image that stayed with Boutelle is when Lemon was being led back to jail. As he was escorted out, he slowed the deputy sheriff enough so that he was able to turn toward his mother. He formed a heart with his fingers and thumbs.

Boutelle made it out of the courtroom before she broke down in tears.