Last summer, Kevin O’Reilly sat around the Meredith police station with other officers and talked about a trend they noticed on the local news.

Stories of police shootings, specifically those that involved someone in a mental health crisis, seemed to pop onto the television every couple of months.

They listed off the recent ones: there was the middle-aged man shot in Belmont, about 16 miles south, whose parents said had been in and out of the psychiatric hospital for PTSD and bipolar disorder. About a year later, a 37-year-old man, who family members said struggled with delusions and paranoia for most of his adult life, was shot while running naked at a Thornton police officer about 20 miles to the north.

The incidents seemed to be circling their small town on the shores of Lake Winnipesaukee, they agreed.

“It’s going to be happening here soon,” O’Reilly half-joked.

Several months later, as the tourist town quieted down and the lake started to freeze over, it was O’Reilly’s name broadcast on the news. He shot and killed a young man in the midst of a psychiatric crisis, who stabbed three people and then charged toward O’Reilly while armed with several knives.

He often thought back to that discussion with his coworkers as a cruel foreshadowing of the night that sent his life spiraling out of control. After handing over his uniform and belt to investigators that night, he never returned to the station where he was employed for nearly 13 years. He spent the next year at home, living on worker’s compensation while attending residential and outpatient psychiatric treatment programs for PTSD, depression and anxiety.

Despite the handful of pills prescribed by his psychiatrist, he largely confined himself to his Laconia home, for fear of fireworks, or rain, or any other number of triggers that would reignite memories from the shooting.

“You predicted it,” a colleague told him, and then added sympathetically, “I can’t imagine what you’re going through.”

In New Hampshire, police officers, who often aren’t sufficiently trained on the intricacies of handling mental illness, are likely the first — and sometimes the only — response to those in a psychiatric crisis.

At the New Hampshire Police Academy, recruits spend 24 hours, or about 3% of their curriculum, learning about how to handle calls that involve mental illness, said John Scippa, director of New Hampshire Police Standards and Training Council.

Mental health advocates say the reliance on the police for mental health responses not only puts people with mental illness at risk but also sets police up for failure.

In New Hampshire, more than 60% of the people killed by police in the last decade struggled with mental illness, according to a Monitor analysis based on 10 years and more than 30 Attorney General reports.

These fatal encounters not only leave families mourning the loss of their loved ones but involved officers, like O’Reilly, with debilitating mental illnesses themselves.

A November night

When O’Reilly clocked in for his overnight shift, it was a blustery, November night. He quietly hoped his shift would be uneventful so he could stay inside the warm station and catch a football game — the Patriots were playing the Ravens that night, he remembered.

He had just changed into his navy uniform and set down his coffee when dispatch radioed in the address of an apartment complex less than a mile away with a domestic disturbance.

O’Reilly instantly recognized the address as David Donovan’s, a man he encountered several times over the last year for mental illness and substance abuse calls.

Before getting a chance to take a sip of his coffee, he braced the rain and headed to his police SUV. O’Reilly followed the same two-minute route he had driven dozens of times — from the police station, past the local graveyard, to the apartment complex.

As he made the final turn into the parking lot, he heard another officer who had just arrived at the scene announce over the radio: “Have units step it up, he has a knife.”

O’Reilly felt the adrenaline surge through him as he stepped out of the cruiser with his gun raised.

“I had no clue what the hell was going on,” he said in an interview with the Monitor. “I left my door open, my car was running, my radio wasn’t on.”

O’Reilly remembered the broad sequence of events the night of Nov. 15, 2020, but some of the finer details alluded him — the entire police interaction lasted only about two minutes. His account of the event was confirmed with witness interviews and a report published by the Attorney General.

He remembered shouting to drop the knives over and over again and Donovan, who had alcohol, methamphetamine and marijuana in his system, responding with nonsensical yelling, a couple of phrases in German, and several expletives.

He remembered Donovan shouting that he was going to steal the police cruiser and the other officer firing his Taser, which only worked partially — one of the prongs bounced off his jean jacket. He remembered Donovan’s face as he turned toward him and began walking toward him, knives in hand.

Then, he remembered shooting him twice in quick succession.

“I held my hand over the bullet wound,” O’Reilly said. “Even though it wasn’t bleeding, I still held my hand over it.”

Donovan whimpered that he didn’t want to die. O’Reilly promised he wouldn’t.

‘Not equipped’

Every year, it seemed like more and more of O’Reilly’s job was consumed by mental illness. He estimated that on a typical night, three-quarters of his calls were to help someone in crisis.

“We’re not equipped or fully trained to deal with that,” he said. “We do our best: we try to talk softer and slower, bring them down. But we didn’t go to school for that.”

O’Reilly’s experience is typical for officers across the state.

Russell Conte, a retired major in the state police and advocate for officer well-being, said mental health calls have dominated the law enforcement profession for many years.

“You could talk to any police leader anywhere and say ‘hey what percentage of your regular service calls are mental health-related,’ and police officers that have been around will say it’s 70 to 80%,” Conte said. “It’s kinda’ always been that elephant in the room.”

Despite the outsized role mental illness plays in the daily responsibilities of New Hampshire police officers, local law enforcement spend a small fraction of their formal training learning how to respond to such events.

Over the last several decades, New Hampshire Hospital — the only state-run inpatient psychiatric hospital — has drastically reduced its census from 2,700 beds in the 1950s to just 180 today. Meanwhile, New Hampshire’s population followed the opposite trajectory, increasing 150% over the same time period, according to census data.

The community mental health resources that were supposed to replace institutionalization are still underfunded and underdeveloped, leaving a gap in care for people with serious mental illness in New Hampshire.

Ken Norton, the director of the National Alliance on Mental Illness NH, likens sending law enforcement to mental health calls to sending a police officer to a house fire.

“The police department is standing there and they’re watching your house burn down and they can’t really do anything because they’re not the right people,” he said. “When police respond sometimes it’s okay, but sometimes it’s not. And sometimes we end up with people that are dead.”

Mental illness all around

O’Reilly joined the Meredith Police in 2008, after serving six years with the Air Force military police in North Dakota and a short stint in Iraq. Like many prospective officers, he joined the police force with idealistic hopes of helping people. He said he rarely felt like he was helping the people he encountered with mental illness.

The only resource he knew to offer them was a ride to the hospital, where they could voluntarily seek psychiatric help. Often, they declined his offer — losing the ability to detect one’s own need for treatment sometimes accompanies serious mental illness.

Unless O’Reilly could prove they were a danger to themselves or others, the legal criteria for an involuntary emergency admission, he felt he had no choice but to leave and wait for the next call that would bring him to their door.

If they did agree to go to the hospital, he said they rarely stayed for long. He’d sometimes respond to a call involving a person he dropped off at the hospital 20 minutes earlier.

“It’s just a repeated pattern,” he said. “There are some people where we go to the house 20, 30 times a week.”

Donovan was what O’Reilly called a “frequent flyer.” Over the course of a year, Donovan had been the subject of hundreds of calls and dozens of police encounters because of mental health or substance use-related issues.

O’Reilly said Donovan’s challenges with mental health and addiction were well-known to most officers at the Meredith Police station. Records from the Meredith Police Department show several instances in which officers asked Donovan to go voluntarily to the Lakes Region General Hospital for an evaluation. Some nights, he complied.

Other nights, despite hallucinating that snakes were attacking him and imposters were plotting against him, he declined and police left.

“There’s no on-call doctors that are gonna come respond,” he said. “There are no on-call counselors that are going to respond to a scene. We’re it.”

A different life

On the one-year anniversary of the shooting, O’Reilly slumped into a faux suede sectional at his Laconia home. He hadn’t slept well.

In his dreams, the night of the shooting played over and over again. Some versions of the dream showed him shooting Donovan. In other versions, he was the one who died.

Now, after sending his kids off to school, O’Reilly sipped on his fourth cup of coffee and rubbed his eyes as a plump pit-bill named Lexi snored on the couch next to him. This is where he siloed himself since the shooting, busying himself with home improvement projects and caring for an array of houseplants.

“I’m not big on being in public places,” he said.

There were too many triggers outside of his home that could drop him back to the November night. There were too many possible threats, which sent his eyes endlessly darting back and forth. There were too many strangers, whom O’Reilly felt certain were aware of what he did and were ready to confront him at every turn.

In most situations, he could find workarounds. O’Reilly, a divorced dad, volunteered to coach his son’s flag football team so that he could watch the games without sitting in packed bleachers. Instead of traversing the isles of Hannaford, he ordered groceries for pick-up at Walmart.

On this day, a 10:30 a.m. doctor’s appointment at Concord Hospital-Laconia for a softball-related shoulder injury was forcing him outside of his comfort zone. He smoked a Marlboro Light on the back porch and downed his morning antidepressants with black coffee.

Inside the orthopedics wing of the hospital, he fidgeted with a toy he stashed in his sweatpants pocket. A support group he attended three times a week on Zoom taught him this strategy to relieve stress when he was in public.

The trip had gotten off to an unpleasant start — during the five-minute drive to the hospital, a Belknap County Sheriff’s cruiser pulled ahead of O’Reilly’s truck. Police cars were a trigger, especially when their lights flashed. His memories of the shooting were bathed in cyan light.

O’Reilly pulled a baseball cap down over his eyes and a face mask over his nose, a uniform he began wearing in public to protect his anonymity.

A few days after the shooting, the Attorney General released his name to the public before releasing details of the event, which brought on an onslaught of criticism from all angles — Facebook commenters, work acquaintances, even his daughter’s middle school friend who told her that her dad was “a cop that kills people.”

He peered into the waiting room and saw a handful of patients reading magazines and scrolling on their phones.

“People,” he said, shaking his head.

He picked out a chair outside the waiting room along an adjoining wall.

It had been a year since the shooting. Six months since the Attorney General, who investigates all fatal police shootings, deemed the shooting legally justified. About a month since he completed a two-week residential mental health treatment program at a Harvard Medical School affiliate.

He thought he should be feeling better by now. But O’Reilly still saw Donovan holding knives in his own house — visual hallucinations are common among people with PTSD. He still felt disconnected from friends and family.

Before the shooting, O’Reilly enrolled in Southern New Hampshire University to earn a master’s in public administration, which he hoped would qualify him for promotions at the station.

He already took a semester off to get a handle on his symptoms. Now, as he struggled to balance paranoia and hypervigilance with online classes, he thought he should have taken more time off. He couldn’t focus on his schoolwork. He wasn’t sure whether he would ever return to the station anyway.

O’Reilly’s house used to be peppered with cheeky law enforcement decorations, like the poster that hung in his bedroom and read “always kiss your police officer goodnight.” Then last year, he rounded up all the trinkets and gave them away.

The only remaining piece of memorabilia was a small statue of the word “police” on the living room console.

“That’ll be gone soon, too,” he said.

He told his therapist that he wanted to distance himself from the profession that once defined him. He resented that he was put in that situation. He resented that no one taught him how to protect his own mental health.

The house was now outfitted with a different set of accessories. A weighted blanket to soothe his night terrors lay across his bed. A pile of toys designed to busy his anxious hands sat on the kitchen counter. A pillbox the size of a book rested beside his bed.

“Everything ended for me,” he said. “My whole life flipped in a matter of two minutes.”

When O’Reilly thinks about what could have changed the outcome of his encounter with Donovan, he doesn’t think back to Nov. 15 — he firmly believes he did everything he could to deescalate the situation in that moment. To him, the opportunity for intervention was weeks and months before the shooting.

It was when the police transported him for voluntary treatment or when Donovan’s mother took him to the hospital repeatedly for mental health treatment.

“Somebody should have listened to her,” he said. “Some where along the line, something is failing.”

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