Officer M.J. Macario has devoted much of his law enforcement career to keeping people out of jail.
In his eight years of police work, the former college professor and retail salesman has tackled a touchy and persistent problem -run-ins between police and the mentally ill that too often end with sick people sitting in jail cells instead of getting help.
Macario has emerged as a leader in the state's efforts to improve the way police deal with people who suffer from mental illnesses or cognitive deficiencies. A trainer for the Raleigh Police Department, he leads classes on handling these vulnerable populations, and plays a key role on the countywide Crisis Intervention Team, which aims to help them receive care instead of jail time.
This year, he is working with a group of mental health professionals to revamp the training North Carolina police officers receive on mental illness. His work earned him kudos from the National Alliance on Mental Illness North Carolina, which honored him with an award last month.
"He's just a poster child for the way law enforcement needs to be," said Deby Dihoff, executive director of NAMI North Carolina. "He's open to learning about mental illness and an advocate for getting people to treatment."
Macario concedes the approach he advocates is a tough sell for some cops. Recognizing mental illness and helping those who suffer from it requires acting more like a counselor than a cop at times. But the key is to use both methods at the right times, he said.
"There are days when we go home and say, 'I put a very bad person in jail today,' and that feels good," he said. "But there are also people who just seem to be there because of circumstances that are not of their own control."
Macario looks like a typical cop, with his shaved head and a muscular frame squeezed behind a bulletproof vest and blue uniform.
But he brought some unusual credentials when he joined the force in 2004 at age 38 - a master's degree in sociology and years of experience teaching college students and selling menswear.
His daughter was born with Down syndrome just days before he started the police academy. She is intellectually and mentally disabled, requiring full-time assistance to attend kindergarten.
His mother, who lives with his family, has Alzheimer's disease, and his father died after a steep mental decline that left him volatile and paranoid.
Macario said these experiences drew him toward cases involving mental illness. His studies in sociology trained him to look for the source of suspects' behaviors, and his family's illnesses taught him to look behind the behaviors to the person.
"It gives me instant empathy," he said.
Knowing the signs
Police encounter people with mental problems in a variety of ways. Sometimes they're called to carry out an involuntary commitment order, or to intervene when loved ones fear a suicide attempt. Others are suspects in nuisance crimes such as loitering or trespassing, or in more serious offenses.
The goal is not for officers to diagnose illnesses, Macario said, but to refer people who show signs of mental illness to be evaluated. He recalls when he was called on a shoplifting charge at a grocery store. The suspect was wearing nice but filthy clothes and staring blankly, clutching the packages of meat she tried to take, not bothering to hide them.
He cited her for the shoplifting charge, but brought her to the county's mental health assessment center instead of jail. Months later, at her court date, she showed up after having received treatment, and the charges were dropped.
"We're in the business of making people accountable for their actions, but if it's possible a person was not in control of their actions, we have to be able to get them to somebody who can consider that rather than just take them to jail," he said. "If mental illness is one of the reasons they're in this situation, putting them in that environment is only going to make it worse."
These types of encounters have increased in recent years, Dihoff said, because of the state's failed mental health reform efforts and the down economy. There are fewer hospital beds, and a lot of people don't take needed medications for financial reasons.
"We're more likely to run into them and more likely to find them when they are at the height of their crisis," Macario said.
A calming influence
Macario grew up in Bethlehem, Pa., in a house within view of the steel mill where his father worked for more than 40 years. Several family members were police officers, and he long considered a law enforcement career.
A knee injury he sustained in his early 20s during a Tae Kwon Do tournament dashed his hopes of passing a physical exam, though it eventually healed.
Instead, he went into academia, earning his master's degree at the University of Virginia. He moved to Raleigh in 1990 to earn his Ph.D. at N.C. State University. He enjoyed teaching there and as an adjunct at Wake Technical Community College, but he found less satisfaction from the research side of academia. He left school and returned to the retail jobs that supported him through college.
He worked at several jobs, including as a manager for Brooks Brothers and S&K Menswear stores in Raleigh. He was working for a company that made custom suits for upscale customers when he happened upon a police recruiting office on his way to drop off some clothes.
He was wearing his best suit and, on a whim, stopped to ask if he was too old to join the force. He wasn't, and he decided to apply, even though the pay was less than he made in retail.
"I always told my kids that you can be anything you want to be, but I wasn't taking that advice," he said.
Shortly after starting on the force, he took part in the county's new crisis intervention program, modeled after a jail diversion program developed in Memphis, Tenn., after a mentally ill person was shot and killed by police.
"It just changed the way I thought about everything," Macario said. "I started to realize how much mental illness played a part in the things I had seen and the people I had dealt with."
He also had a knack for dealing with such cases, successfully talking down potential suicides or mentally ill people in crisis. He was soon asked to teach the portion of the class on "de-escalation," calming a potentially dangerous situation using methods such as making eye contact and speaking in comforting language.
This talking down is a marked shift from regular police tactics, which focus on establishing command and control, which can further aggravate a mentally ill person in crisis.
In 2009, Macario became a full-time trainer at the police academy, where he teaches parts of the law enforcement course all Raleigh recruits complete, including the eight-hour mental illness block he is helping revamp.
Macario knows changing a training course won't immediately stop everyone who needs help from going to jail. But he hopes by reaching one officer at a time, he can make it happen less.
"Like any giant problem, you have to keep picking away at it," he said. "If one person has a better experience, if one officer is able to detect a problem, then I've helped."
