Behavioral Science and the Secret Service: Toward the Prevention of Assassination (1981)

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SUMMARY OF WORKSHOP AND PLENARY DISCUSSIONS Each conference participant, including Institute of Medicine staff and Secret Service representatives and consultants, attended one of three workshops held on both days of the conference. Workshop sessions were conducted simultaneously and discussions ranged across the entire subject matter of the conference. Workshops were chaired by Elissa P. Benedek and Robert Michels (Group A), Shervert H. Frazier (Group B), and Charles H. Whitebread (Group C). Workshop discussions, together with discussion preceding and following presentations during plenary sessions, are summarized under the following major headings: Assessing Potentially Dangerous Behavior ........ 24 Identifying Possible Sources of Danger to Protected Persons 37 Suggested Approaches to the Study of Assassination ... 44 Relationship between the Secret Service and the Mental Health Community 49 Management of Dangerous Subjects 59 Legal and Ethical Aspects of Investigative Activities and Interventions 68 Improving Agency Operations: Resource Allocation and Management Issues 71 Guidelines for Establishing a Research and Consultation Capacity in the Behavioral Sciences and Clinical Disciplines . . 74 Promising Research Opportunities: Some Specific Suggestions 77 Career Patterns and Selection of Special Agents .... 82 Training of Special Agents ..... 85 23

Introduction This conference of behavioral scientists and clinicians was convened to bring their knowledge to bear on the problems of identifying, assessing, and monitoring persons likely to threaten the safety of those the Secret Service protects. The conferees hoped to assist the Secret Service Intelligence Division in devising responsible and appropriate ways to determine the effectiveness of its information-gathering activities and interventions with persons and groups of concern.1 The Secret Service Intelligence Division is daily faced with a great many difficult decisions—about the likely dangerousness of each case brought to its attention, about the management of those believed to pose risk to persons protected by the Service, and as to whether persons formerly considered dangerous are still a source of risk, to name a few. These decisions must be made under conditions of considerable uncertainty and high risk. Predicting human behavior with any degree of accuracy is difficult at best, and errors in judgment can have consequences as grave as the assassination of the president of the United States. ASSESSING POTENTIALLY DANGEROUS BEHAVIOR About 20 new cases per day are brought to the attention of the Intelligence Division. These cases are referred to Secret Service field offices throughout the country, where they are assigned to special agents for investigation. For each new case, or "subject" in Secret Service terminology, special agents must make a dangerousness determination within five to 14 days, depending on the priority of the case: they must decide whether the subject is to be classified as "dangerous" or "not dangerous" to persons protected by the Service. In the course of making their dangerousness determinations, Secret Service special agents are required to collect a great deal of information about the subject: demographic and identification data (address, place of work, date of birth, marital status, aliases used, and so forth); information about the subject's education, training, and skills, including familiarity with weapons; family history; mental history; criminal history; citizenship status; military service record; addictions and deviations; organizational affiliations; and "directions of interest" (those persons or targets about whom the subject has expressed or otherwise indicated hostile or unusual interest). Handwriting samples, photographs, and other identification materials are also collected if deemed relevant. The dangerousness decision is usually made before the investigation of 24

the subject has been completed. Once all relevant information has been assembled, agents file a written report, which contains the findings of the Investigation, the dangerousness determination, all correspondence from and about the subject, and any other pertinent materials. Portions of this report are stored in a computer at Secret Service headquarters. To obtain information about a subject, special agents typically interview him or her in person and consult a variety of other sources and records, including the FBI, military or hospital records, and the subject's family, friends, or associates. For subjects they consider dangerous, special agents must devise ways to keep track of their activities, manage their behavior, or otherwise reduce the risk they pose to protected persons.* The vast majority of all subjects investigated by special agents are judged not dangerous. Approximately 300 subjects out of a total of some 26,000 fully investigated subjects on file with the Secret Service are presently considered dangerous. (The remainder have never been considered dangerous or were considered dangerous at some time in the past.) Problems of Making Determinations about Dangerousness The dangerousness determinations that must be made by special agents involve estimates or "predictions" about future behaviors, and are always made under conditions of uncertainty and high risk. Although agents try to reduce uncertainty by obtaining as much information about the subject as possible before they make their decisions, Secret Service personnel are not sure that the information routinely collected is directly relevant to predicting whether a subject will or will not engage in behavior that might actually harm a protected person. They have also expressed concern about how the various items of information collected should be best used to make a decision.** At present, special agents base their dangerousness decisions on their admittedly subjective impressions gained during interviews with subjects and on a few specific items of information, which may differ from agent to agent. The Secret Service hoped that conferees would have some suggestions for improving agent decision-making processes, making them more reliable and valid. Interventions and management techniques used with subjects considered dangerous are discussed under Management of Dangerous Subjects, page 59. **See Questions Raised by the Secret Service and Summaries of Conference Responses, page 7. 25

Conferees emphasized that prediction, judgment, and making decisions are highly fallible and difficult tasks, even under the best of circumstances, and that Secret Service personnel should not expect a panel of experts to be able to help them improve their capability in these areas to a dramatic degree. Thus, the Service should expect modest and incremental gains, and not "breakthroughs" as a result of conferee suggestions in these areas. Several reasons underlay this less than optimistic viewpoint. First, accurate prediction of individual behavior has been demonstrated repeatedly to be largely unsuccessful, even when a great deal is known about the persons whose behavior is being predicted and predicted behaviors themselves, and when those making the predictions are experts in the relevant fields.* Conferees unanimously agreed that behavior likely to occur in the distant future is predicted with much less success than behavior expected to occur in the very near future. In fact, the shorter the time span between the prediction and the expected behavior, the more likely the prediction will be accurate. Thus, any attempt to predict that a Secret Service subject is or is not likely to be dangerous to a protected person is apt to be useless unless a very limited time frame is considered. Second, when the behavior being predicted occurs infrequently—or has a "low base rate"—accurate prediction of who will and will not engage in it is even less likely. Assassination and assassination attempts on political leaders are rare events, at least in the United States,** particularly with respect to persons presently protected by the Secret Service. Under such circumstances, the behavior is bound to be overpredicted. That is, there will be many "false positives" among those predicted to engage in the behavior—persons identified as potential assassins who will not attempt to assassinate a *See presentation by John Monahan, page 129. **An impression that U. S. history is rife with presidential assassination attempts may be caused by their high proportion—10 of 40 presidents have been attacked—but the attackers total only 12, including the man alleged to have shot President Reagan March 30, 1981. (President Ford was the subject of two separate assassination attempts, and President Truman was the subject one attempt involving two assailants.). 26

protected person.* A third problem is that human judgment and decision-making are known to be highly fallible and inconsistent, even among so-called experts.** Yet another problem compounds the difficulties of making accurate predictions of subject behavior: because the Secret Service cannot take the risk of not intervening with a subject when it thinks it should, the Service is to some extent unable to learn whether its predictions as to dangerousness are successful or not. The possibility, however slim, that an untoward event might occur makes non-intervention unacceptable in view of the Service's mandate to "protect," with the result that the Service is limited in its capacity to evaluate the level of effectiveness of its own operations. Acknowledging the fallibility of human judgment, many conferees nevertheless agreed with Kenneth Hammond that development of a "decision support system" might assist special agents in their judgments about dangerousness and other matters. A decision support system is a method by which the advice and skills of specialists can be made available through computer modelling. Specialists in various fields considered relevant to the decision, such as psychiatry, psychology, and criminal justice, can provide support by identifying the variables which they themselves consider important in assessing persons for dangerousness, and make their own decision processes available for scrutiny and computer modelling. Additionally, a cadre of such experts could be on call to assist agents personally in deciding how to evaluate difficult cases. The Concept of Dangerousness While it may be necessary from an administrative standpoint to have special agents decide that a subject is dangerous or not dangerous, many conferees questioned the appropriateness and *Some suggestions for dealing with the problem of low-base-rate behaviors are discussed under Suggested Approaches to the Study of Assassination, page 44, and in memoranda by Monahan and Franklin Zimring, pages 179 and 183, respectively. **See memorandum by Kenneth Hammond, page 175. 27

relevance of this dichotomy for subsequent decisions about subjects.* A simple division of all subjects into categories dangerous and not dangerous fails to recognize that (1) dangerousness is not an enduring personality trait, but rather a state that may be dependent on many factors; (2) the extent to which a subject may pose risk to a protected person will vary over time and with circumstances; and (3) persons vary considerably in the level of risk they may pose, and cannot be considered simply dangerous or not dangerous. Some conferees, including psychiatrists Robert Michels and Loren Roth, questioned the utility of making dangerousness determinations at all, because such decisions at any one time are likely to be highly unreliable and invalid.** The important and relevant task for Secret Service agents, as for clinical psychiatrists, they said, is to devise a management plan or, in Michels' words, "a process for making an infinite series of decisions" about how the subject should be handled to neutralize or otherwise mitigate the hostility he or she manifests toward protected persons. Many conferees felt that if the concept of dangerousness is to be retained and used for decision-making about subjects, the Secret Service should explore and attempt to develop indicators that would permit subjects to be rated and compared with each other in terms of the relative risk they pose to protected persons and also in terms of their own level of dangerousness at different points in time. In the category of dangerous subjects, the Service should be more explicit about the level of concern it has about each subject in relation to all others and about each subject over time, and should develop behavioral indicators to measure these gradations in dangerousness. Such an exercise and its application would help the Service begin to identify not only whom it should be most concerned about and when, but also what behaviors might be immediate preludes to assassination attempts. Mental Illness and Dangerousness Approximately 90 percent of all persons the Secret Service presently considers dangerous to protected persons gave some indication of mental disorder before coming to the attention of the Service. Conferees were particularly interested in determining why this is so, and whether the level of concern with the mentally ill is *Secret Service representatives noted that if a third category were added, falling between the two extremes, agents would be tempted to overuse it. **See Roth's memorandum, page 181. 28

justified. They also offered a variety of suggestions for assessing and managing emotionally disturbed subjects. Secret Service concern with emotionally disturbed people who make threats against protected persons may to some extent reflect the widespread popular belief that the mentally ill are violence-prone. Because of their relative unfamiliarity with mental illness, Secret Service special agents may tend to view the behavior of the mentally ill as dangerous because it seems so unpredictable, while the behaviors of those without apparent mental disorder may seem more rational. (No data were available on the incidence of mental disorder among subjects the Secret Service has never considered dangerous.) Conferees emphasized that much violent behavior is state-dependent, occurring only at times when the person in question is in specific situations, under particular stresses, or in a particular state of mind. For example, a person may pose risk while intoxicated, but not at other times. A manic patient may be violent only when off medication. As pointed out by Roth, a competent clinical examination of a patient or subject known or anticipated to be violent should always involve a "meticulous examination of the past violent episodes or ... threats in terms of what state the person was in."* Role of Mental Health Professionals in Assessing Dangerousness Many clinicians felt that mental health professionals have relatively little to offer in the way of predicting whether and when a Secret Service subject might attempt to harm a protected person. In their opinion, Secret Service agents are probably as expert in this area as anyone, and perhaps more so than many mental health professionals, given agents' extensive experience in responding to "threats" and other behavioral manifestations of hostile intent toward protected persons. Although certain clinicians experienced with violent patients may be fairly well equipped to predict imminent violence, mental health professionals in general have not been shown to be better than anyone else in making predictions about behavior which might occur in the distant future under changing conditions. Clinicians and others felt particularly uncomfortable about the notion of classifying subjects as either dangerous or not dangerous, for reasons discussed earlier. The probability that a Secret Service subject will do violence to others or himself is likely to fluctuate *This topic is also addressed by Shervert Frazier in his presentation, page 133, and by R. Kirkland Gable in his memorandum, page 171. 29

over time and must be reevaluated through periodic (or nearly continuous) monitoring. Thus, clinicians preferred to view the task of assessment for dangerousness as an ongoing process and not distinct from the monitoring and management tasks to which special agents are also assigned. For the purpose of assessing subjects for dangerousness, conferees agreed that mental health professionals might usefully provide Secret Service agents with • greater understanding of the course and fluctuations of mental disorders and emotional disturbances over time, and the relationship between diagnostic categories and behavior • assistance in identifying subpopulations of the mentally ill who are or might be dangerous to others or themselves • guidance concerning the types of questions or items to include in interview protocols to assess risk • techniques for interviewing potentially dangerous persons* • ad hoc consultation in the evaluation (assessment) of difficult, puzzling, or ambiguous cases. Effect of Group Affinity on an Unstable Person In assessing a subject for dangerousness, Secret Service special agents routinely inquire about the subject's group affiliations. Although the Service has no concrete evidence about the influence of groups on individual behavior, agents do tend to have a higher level of concern about a subject who belongs to or identifies with a radical extremist group, particularly if the group espouses unusual religious or political beliefs and has a history of violent activity. In its desire to know more about the influence of groups on individual behavior, the Service asked conferees to consider the question, "What do we know about the potential dangerousness of a person under the influence of a group—particularly an unstable individual?". Although this topic did not constitute a separate agenda item at the conference, one workshop group explored it briefly, at the request of its Secret Service representative. *See Frazier's presentation and paper by Frazier and colleagues, pages 133 and 93, respectively. 30

Secret Service consultant Edwin Megargee said that there is a large body of theory and empirical research on the psychology of groups and group behavior, and on the functions of group membership for the individual. In general, an unstable person may be motivated to join a group out of a desire to enhance his status by association with its influential members, or to be able to diffuse or suspend a sense of personal responsibility for his actions. Such persons may be inclined to engage in activities they think will please the group leadership. Conferees noted that the leadership of groups with a serious mission (however farfetched or irrational that mission may seem to outsiders) are perennially concerned about the marginal individual who fancies himself to be a member in good standing and is eager to serve, but who is likely to blunder while attempting to fulfill his own personal needs in the name of the group. Conferees tended to agree with the Secret Service in its concern about unstable persons who identify with radical groups. Brian Jenkins said he would be most worried about fringe members of fringe groups. Workshop discussants did not directly address the issue of the potential dangerousness of the leadership of such groups, though one conferee cautioned that group leaders can be extremely manipulative and attempt to engage a police organization such as the Secret Service in "guerilla warfare" to achieve their goals. Such skirmishes can be extremely unpleasant as well as exhausting for a government agency, and may even escalate to violence. Charles Whitebread was of the opinion that police organizations tend to become unduly distracted by groups—particularly those they do not like—and by the very fact that an individual belongs to a (radical) group. He advised the Service to be mindful of civil liberties issues when dealing with such groups and their members. Assessment Procedures: Suggestions for Improvement On the basis of what they learned in pre-conference briefings and in plenary and workshop sessions, conferees made a number of suggestions for improving the information collected about subjects, the field procedures and instruments used, the written reports detailing the findings of subject investigations, and information storage and retrieval procedures. Information Collected Conferees questioned the relevance of some of the specific items of information the Secret Service presently collects. For instance, some wondered whether sexual preference (homosexuality or heterosexuality) bears any relationship to whether a person might or 31

might not be harmful to protected persons. They also noted that, typically, much of the information collected is not used in making dangerousness decisions or is collected after decisions are made to be on record should the need arise. That is, the relationship between the data collected and the outcome being predicted by the agents' decisions (i.e., dangerous or not dangerous) is unclear. As previously noted, Secret Service representatives readily acknowledge that present decisions result from a largely subjective process, not systematically or consistently related to the data collected from subjects and other sources. Inventory of Potentially Relevant Assessment Items Conferees reached no conclusions as to which items of information are relevant for decisions about dangerousness, but they did suggest that the Secret Service devote serious attention to this issue and perhaps engage some outside help in revising its present list of items investigated by special agents.* Because relatively little is presently known about the items of information that are truly related to dangerousness, conferees suggested that the Service anticipate that whatever items are included in the revised data collection list will have to be further refined over time, with those items empirically determined to be irrelevant eliminated and perhaps replaced by new ones. The goal should be to reduce the amount of data collected to only a few items, which are shown by experience and research to be highly predictive with respect to dangerousness to protected persons. This goal, however, will not be achieved without extensive trial and error, and should not be regarded as attainable in the near future. Conferees said that data collected and recorded about subjects should be directly relevant to decision tasks, and not merely for record keeping purposes. Conferees also felt that the notion of relative risk should be built into the data collection system. That is, response categories to questions asked of subjects and others interviewed in the process of investigation should enable agents to rank order subjects in terms of their level of dangerousness with respect to each other and also with respect to themselves at different points in time. (This issue will be discussed further below.) *0ne list of data elements suggested for use in the assessment process was proposed by Frazier and colleagues in their paper. 32

At the outset of an investigation, conferees suggested, the Secret Service should be collecting information about the motivations, feelings, and attitudes of subjects toward protected persons; current psychological functioning and mental history; criminal history; weapons knowledge and weapons procurement activities; subject mobility and other indicators of ability to carry out threats or inflict harm on protected persons; and a variety of factual background data. (The Secret Service already collects information about most of these items, as indicated earlier.) The members of one workshop group compiled a list of factors they felt should give cause for concern, if evidenced by subjects during interviews or if otherwise ascertained. They also noted a few factors they thought might indicate decreased risk to protected persons. They did not, however, specify the relative importance of any of these factors in assessing risk to protected persons, nor did they suggest how these factors might be used collectively to reach dangerousness decisions. The following were suggested as possible indicators of increased risk: history of emergency psychiatric admission(s), history of extremely bizarre behavior, claims of personal relationships with protected persons that are remote, lack of concern for self-preservation, concern on the part of significant others about the subject's behavior; fixed ideas, obsessions, or compulsions concerning one or more protected persons; extreme or seemingly irrational hostility toward protected persons; evidence of intense interest in a protected person as suggested by such things as the presence of their travel routes or itineraries in the subject's home; repeated or frequent threats to harm a protected person; episodic or binge drinking, history of alcoholic blackouts; involvement in fringe organizations with a history of violence; history of unemployment or employment difficulties; presence of situational stresses (such as recent losses or life changes) that might interact with underlying mental disorder; absence of social supports (family, friends); "wanderlust" (no permanent home or participation in stable social relationships); exaggerated concern with the world situation; idiosyncratic gripes againt the government, and especially feelings of having been cheated or taken advantage of by the government; presence of hate literature in the home; caches of weapons in the home; indicators of ability to follow through on or carry out threats; and evidence of past killing.* *There was disagreement as to the relevance of this factor. Some conferees thought it important to determine the context in which the killing had occurred and felt that having killed legitimately (as in time of war) would not be a relevant factor. Others thought that the fact of having killed another human being, whatever the context, was relevant. 33

In someone already being followed up by the Secret Service, any of the following changes in status, coupled with the protected person traveling to the subject's area of residence, could indicate increased risk: increases in drug or alcohol use, loss of job, or loss of a significant stabilizing relationship. The following factors were viewed as indicators of decreased risk: stable employment, a stable family situation and other conventional bonds, the presence of children, extreme psychological disorganization, and low intelligence. Field Procedures and Instruments Used Conferees were unanimously agreed that the personal interview is an indispensable tool for assessing the potential dangerousness of subjects, even though it may be an inherently stressful experience for many special agents. A personal interview can yield not only hard information about a subject (which may be valuable for subsequent identification and management purposes), but also can provide many clues to the motivations and dynamics of a subject's interest in protected persons. Most special agents assessing subjects for dangerousness find the personal interview to be the most helpful source of information for decision-making. A few conferees, aware of the fact that most special agents assigned to the task of assessing subjects for dangerousness are white middle class males, suggested that male-female teams of interviewers might be more successful than male-only interview teams in eliciting a full range of useful information from subjects. (This suggestion could be experimented with on a limited basis to test its validity.) They also felt that female interviewers, whether or not they are teamed with male interviewers, should be used when interviewing female subjects.* Noting that some threat activity and other behaviors considered potentially dangerous to protected persons are "state dependent," other conferees, notably R. Kirkland Gable and Loren Roth, suggested that interviewing and assessing subjects during periods when they engage in these behaviors might be useful. For an alcholic who threatens only when drunk, for example, more relevant information about his intentions might be forthcoming when he is intoxicated than when he is sober. Similarly, for a manic depressive subject who appears to pose risk when in a manic state, interviewing him or her *See presentation by Frazier and paper by Frazier and colleagues, pages 133 and 93, respectively. 34

during a manic episode might be illuminating. This may involve interviewing such persons while they are hospitalized. Special agents are instructed to elicit information on the list of topics mentioned earlier, but there is no standard and prescribed format for conducting the interview or reporting the information from it in written form. Interviews are open-ended: all topics are covered, but the order in which questions are asked is not specified, nor must questions be worded in a particular way. Rather, agents pursue leads and ask follow-up questions as the interview situation seems to dictate. Some conferees suggested that the data collection effort would be both more reliable and more useful for decision-making (and subsequent research and analysis) if a standard format and structured interview protocol were used. Others felt, however, that if a more structured format is adopted, the use of imaginative probes and follow-up questions based on hunches and intuitions should also be permitted and encouraged. Information about subjects is elicited not only from the subjects themselves, but from a variety of sources, making it likely that there will be factual discrepancies among sources. For instance, agents may hear one set of facts about his employment history from the subject himself and a different set from his spouse or close associate. Some clinicians wondered how such discrepancies are recorded and resolved. Scaling Dangerous Attitudes and Behaviors As indicated earlier, conferees urged the Secret Service to build the notion of relative risk into its data collection instruments. They felt that too much emphasis is placed on determining whether a subject is or is not dangerous and not enough attention devoted to rank ordering the level of risk the subject poses in relation to other subjects at a particular time, and in relation to the attitudes and behaviors the subject might exhibit at some future date. One method of building gradations in dangerousness into the assessment procedure is to scale the response categories to questions involving attitudes and behaviors thought to be related to dangerousness. In the virtual absence of the criterion behaviors (assassination and attempted assassination) among subjects, conferees suggested that an index of undesirable events or threshold behaviors short of assassination be developed. One such behavior might be writing a letter in which the subject expresses a desire to blow up the White House. While this behavior might indicate that the subject is dangerous to the president and members of his family, it would be considered less dangerous than evidence that the subject is tracking the president by plotting his itinerary on maps at home, which in turn would be less dangerous than evidence that the subject appeared in proximity to the president with a weapon or stalked him with a weapon on several occasions. Attitudes could similarly be scaled to indicate the level 35

of danger posed by the subject in relation to other subjects at a particular point in time, and in relation to attitudes manifested by the subject when reassessed in the future. Written Reports and Information Storage and Retrieval As noted earlier, dangerousness decisions are frequently made independent of the (sometimes vast amount of) information collected and reported on a subject. Written reports typically contain a great deal of narrative material from which it is difficult to cull relevant information. Although information about a subject in narrative form may be useful for some purposes (such as for advance work when a protected person travels to a subject's area of residence), narrative portions should be written in such a way that the information relevant to decision-making is readily apparent; alternatively or additionally, information should be extracted from the narrative material, coded, and stored in the computer for retrieval and analysis. In short, the written reporting requirements should be carefully examined, and unnecessary narrative material eliminated. Consensus Suggestions for Improving the Assessment Process Conferees reached substantial agreement that the following suggestions would considerably improve the task of assessing Secret Service subjects for dangerousness: • The entire assessment process should be standardized and rationalized. The information collected, field procedures and instruments used, and the reporting and information storage and retrieval process should be streamlined and made uniform across all cases. • Data collected and filed on each subject should be directly relevant to decision-making. Careful attention should be directed to determining which items of information are pertinent to decision-making, and these should be retained or eliminated according to their empirically demonstrated utility. • A more efficient information storage and retrieval system should be developed. Questionnaire items used to collect data on subjects should be preceded for computer use, and all relevant data should be stored in the computer in an easily manipulable form and readily available for use. 36

• Data collection instruments should contain many scaled items that facilitate rank ordering of behaviors and attitudes of subjects in terms of the degree of danger different subjects pose to protected persons. • The written report form should be redesigned to highlight relevant information. • A decision support system would be a useful device to assist agents in making their dangerousness decisions. IDENTIFYING POSSIBLE SOURCES OF DANGER TO PROTECTED PERSONS One of the critical concerns of the Secret Service Intelligence Division is to learn whether it is currently identifying and monitoring those persons most likely to pose risk to the safety of those it protects. Of the roughly 26,000 cases that the Service has investigated, approximately 300 subjects are presently considered dangerous to one or more persons protected by the Secret Service. The number of dangerous cases varies from day to day, as new cases are added and others (no longer considered dangerous) are dropped. Current Case Referral and Case Finding Procedures The majority of cases the Secret Service investigates are referred by the White House, law enforcement agencies, and other federal, state, and local government agencies. Foreign intelligence, private organizations, and individual citizens are other sources of referrals. To identify organized or terrorist threats to protected persons, the Service uses a network of interagency and international contacts developed for this purpose. Typically, cases referred to the Secret Service for investigation involve threats, either orally or in writing, to harm one or more protected persons, or other indications of risk to such persons, if unchecked. In accordance with Secret Service guidelines, for instance, the White House mail room forwards letters containing references to assassination or terrorist activity, direct or implied threats toward anyone, extremely abusive or obscene language, and mention of unusual grievances against the government or exaggerated demands of protected persons, among other things. White House telephone operators refer phone calls meeting essentially the same criteria. White House visitors, or "callers," whose language or activities appear to pose risk to protected persons are referred to the Service's Washington field office. 37

Observations and Suggestions for Improvement Many conferees questioned the adequacy and comprehensiveness of current referral and case finding practices. First, they had serious reservations as to whether present procedures would necessarily alert the Service to all potential sources of danger to protected persons. They were also concerned about possible misunderstandings and communication failures, even on the part of government entities with well established referral procedures. Some conferees noted that, apart from receiving some information on the activities of groups, almost all incoming referrals are from announced or self-identified threateners—persons who, through their oral or written communications or other behaviors have already revealed their hostility or sinister intentions and desires. Several conferees pointed out that some persons who do not signify their feelings and intentions beforehand may, in fact, be far more lethal than announced threateners. Some threateners may simply be engaging in expressive behavior and have no serious intention of inflicting harm on protected persons. The same might apply to many of those who repeatedly threaten to harm protected persons. The Secret Service, of course, is well aware of this possibility.* Upon investigation by Secret Service special agents, many announced threateners are found to have a history of mental or emotional disorders. Clinicians and other conferees pointed out, however, that while some mentally ill or emotionally disturbed persons may be violent under some circumstances, many will never be violent; and they cautioned that the Service's concern with disturbed persons may be unwarranted in many cases and deflect attention and resources from more viable sources of danger. Further, as noted by some conferees, including Loren Roth, in most instances considerable cognitive ability, capacity to plan, and personal organization would be required to penetrate the Secret Service defensive system and actually carry out an assassination. Highly "disorganized" persons would most probably be unable to muster the personal resources to carry out a threat, no matter how ominous their communications may seem. While some of the mentally ill may give "signals" (however unclear to the layman) that they are on the brink of attempting an assassination, in Walter Menninger's words, "I don't expect that real assassins are going to provide the prior clues . . . [Secret Service agents typically] get from the mentally ill threateners." Michels suggested that persons in need of psychiatric care but who have never sought it and have not been evaluated by mental health professionals *See presentation by Brian Jenkins, page 145, on the credibility of threat messages. 38

might pose greater risk than the mentally disturbed who have been evaluated and treated. The Secret Service is, of course, not unaware of these points. As Saleem Shah summed up the gist of this argument, a person "not foolish enough to open his mouth," and not obviously mentally ill might be able to evade the intelligence network and penetrate the Secret Service security system. Not all conferees shared this view, however. Marvin Wolfgang, for instance, noted that among successful assassins there might also be those who give no thought to escape and are willing to die in the process of assassinating their target. For such cases, he said, "one does not need a high degree of planning" nor "a high degree of intelligence."* Elissa Benedek and others noted the possibility—indeed probability—that the present referral system might be less than fully dependable. This may be so, despite the fact that, in the view of Secret Service representatives, there has been renewed spirit of interagency cooperation in recent years, and it is in the best interests of the referring agency to notify the Secret Service routinely and promptly when a case appears to pose "protective intelligence" problems. Flaws in the referral process might be the result of administrative inefficiencies on the part of the referring agency, or insufficient understanding or genuine differences of opinion as to what, whom, and when to refer.** Non-Traditional Sources of Risk to Protected Persons In the opinion of some conferees, the Secret Service at present may be too preoccupied with the mentally disturbed and with persons who fit the profile of a would-be assassin found in the report of the National Commission on the Causes and Prevention of Violence: a white male "loner," often with a history of maladjustment and marginality, likely to be acting on his own rather than as a part of *Secret Service personnel are particularly concerned about subjects who evidence suicidal tendencies, especially when combined with extreme hostility with or without overt threats toward one or more protected persons. The Service monitors such subjects very closely, in the awareness that they are unlikely to be deterred by conventional sanctions. **The Secret Service does issue referral guidelines to law enforcement and other government agencies. 39

a conspiracy.* More attention, they felt, should be devoted to anticipating new and different potential sources of danger: women and minorities, terrorists, violent radical extremists, and political dissidents or persons and groups with legitimate policy concerns or grievances against the government (in contrast to persons whose political concerns are driven by mental illness), to name a few. More time devoted to case finding among such types of persons and groups might be well spent, they felt, in view of rapid changes in the social, economic, and political climate in the United States and abroad in recent years, which make past experiences with assassination and assassins less appropriate as guides for the future. As pointed out by Secret Service representatives, however, identifying and monitoring potential but as yet "unannounced" threats to the safety of protected political leaders could be extremely difficult from a technical standpoint; and, as Loren Roth noted, could infringe on the civil rights of persons so identified. Women and Minorities A number of conferees, including Elissa Benedek, Sara Eddy, and Robert Fein, advised the Secret Service to take the possibility of women as assassins very seriously. Menninger noted that the previous two attempted presidential assassins were females.** And Secret Service representatives mentioned they thought the number of women making threats against protected persons was on the rise (though they had no precise figures available for conferees). Finally, some conferees speculated that whatever the present level of female threat activity, with the general liberation of women in the United States, threats from women are likely to increase in the future.*** *Milton Eisenhower et al., To Establish Justice, To Insure Domestic Tranquility, Final Report of the National Commission on the Causes and Prevention of Violence (Washington, D. C.: U. S. Government Printing Office, 1969), pp. 122-24. **The conference was concluded prior to the attempt on President Reagan's life by John W. Hinckley, Jr., on March 30, 1981. Lynette ("Squeaky") Fromme attempted to assassinate President Ford on September 5, 1975, in Sacramento, California; and Sara Jane Moore attempted to assassinate President Ford on September 22, 1975, in San Francisco, California. ***See paper by Frazier and colleagues, page 93, for fuller treatment of the issue of female assassins. 40

As with women, the Secret Service caseload of blacks, Hispanics, and other minorities is increasing. Because minority groups have become politically visible and vocal in recent years, conferees thought the Secret Service should anticipate a higher level of threat activity from such groups in the future. Terrorists Conferees echoed the worldwide concern over terrorism. From the point of view of daily Secret Service operations, however, agent responses to dangers from terrorist conspiracies are very different from their typical evaluative activities with emotionally unstable threateners. A different type of judgment is used in assessing and responding to dangerousness of a terrorist group; in such a situation, the Secret Service (along with other government agencies) employs procedures more like those of a criminal investigation, rather than the usual protective intelligence evaluation which includes assessing many personal and psychosocial factors.* Political Dissidents Charles Halpern, among others, raised the possibility that persons and groups having specific political grievances or policy disagreements with government leaders may engage in violence to achieve their goals. Such persons would be drawn from populations quite different than the populations from which the mentally disturbed cases with which the Secret Service is presently so heavily concerned are drawn. Other Sources of Danger to Protected Leaders As many conferees observed, public appearances by protected leaders in certain situations and settings may enhance their risk of attack from persons and groups with sinister intent. Some risk to their lives may also be brought about by the behaviors of the protected leaders themselves.** Problems in predicting whether and when an individual might engage in behavior harmful to a protected person, coupled with the many difficulties and dilemmas associated with monitoring and *See memorandum by Jenkins, page 177. **Presentations by David Hamburg and Walter Menninger are relevant here, as is Saleem Shah's paper (pages 13, 147, and 121, respectively). 41

otherwise managing subjects identified as dangerous (to be discussed below), make it essential that other means of minimizing risk to protected persons be explored. Situations and Settings That Enhance Risk Several conferees suggested that the Secret Service analyze situations and settings in terms of the level of risk they may pose to protected leaders. Public appearances of protected persons in particular geographic areas may be inherently dangerous, and certain types of situations and settings may be relatively easy to penetrate or present unusual difficulties for Secret Service protective units. For instance, appearances of protected figures among large and excited crowds, such as at national political conventions, enhance risk no matter how much security is provided. Similarly, the volume of threats may be higher during presidential campaigns and periods of national crisis or emergency, making alternative or special protective strategies advisable. One suggestion, proposed by Patricia Wald, was to analyze the situations in which assassinations and assassination attempts have occurred, both in the United States and abroad, to determine which of them might be likely sources of future risk to American government leaders (and visiting dignitaries, when protected). Such a study, which could be approached historically, might include examination of the concept of "defensible space" and investigate the methods of successful and would-be assassins. Charles Whitebread suggested that there may be relatively simple technological devices already in existence or soon to be developed that could greatly assist the Service in its task of situational protection. Such devices might include physical barriers or metal detectors installed along parade routes and at other entry points to areas where public appearances of protected persons are scheduled. A third suggestion was to examine fluctuations in the volume of threats to protected persons in relation to political and public events, the behaviors of the protected, and other situational or environmental factors deemed relevant, in order to plan appropriate defensive strategies during empirically determined periods of high risk.* *Franklin Zimring's memorandum, page 183, is relevant here. 42

General Availability of Weapons Conferees noted that the ready availability of weapons in the United States is a factor that must be emphasized in any discussion of violence, however naive or unsophisticated it may appear to restate the obvious. There was no question, in the opinion of conferees or Secret Service representatives, that weapons availability substantially enhances the risk of harm to protected persons. Intelligence investigations of Secret Service subjects always inquire into weapons knowledge and possession, but the Service is virtually powerless to control a dangerous subject's access to weapons. This fact was Illustrated by a Secret Service case presentation about a person who acquired a gun promptly after being discharged from a mental hospital and, while supposedly en route to another mental hospital in a different state, shot and killed a Secret Service agent. Conferees said that the problem of weapons availability must be resolved through the political process, and conceded that an extensive discussion of alternative remedies was beyond the scope of the conference. They also felt that present federal legislation prohibiting the sale of weapons to persons who have been convicted of a felony or are "mentally defective" is insufficiently broad and inadequately enforced. They supported a suggestion by John Lion that any subject who has been judged dangerous by the Secret Service should be barred from access to weapons. Behaviors of Protected Persons Do protected leaders behave in ways that facilitate attempts on their lives? Are some leaders "danger prone"? These questions were briefly entertained in plenary and workshop discussions, and are addressed more fully in presentations by David Hamburg and W. Walter Menninger, and in Saleem Shah's paper. Some conferees suggested that protected persons, particularly presidents, may contribute to attempts on their lives by deliberately exposing themselves to situations of high risk—for instance mingling in crowds and "pressing the flesh." Hamburg commented that presidents, presidential candidates, and other elected leaders say they want to mix with ordinary citizens for two reasons: to demonstrate that they do and can interact meaningfully with the rank- and-file and not just with elites; and to create opportunities for the public to explore their knowledge, views, and skills, and ultimately to test their qualifications to hold high office. Other conferees suggested that less lofty motivations, perhaps shared by many celebrities and public figures, may underlie this risk-taking behavior. 43

Limiting the Exposure of Protected Leaders Though most of their attention and energies were directed elsewhere, some conferees briefly touched upon possible ways to limit the exposure of presidents and other protected persons to potentially dangerous situations. Hamburg, for instance, suggested that there may be equally effective, though more sheltered, settings in which such leaders can achieve the dual goals cited above.* Several conferees, and Secret Service representatives as well, however, thought it might be difficult to convince public leaders that they should refrain from the types of exposure they may feel are important. Robert Michels observed that "it is going to remain the Service's problem of maximizing the protection within the domain of freedom that we allocate our leaders." Nevertheless, Michels and several others shared the view that protected leaders might be induced to modify their behavior if "mandated" to do so by other authorities and if in so doing they did not give the appearance of personal cowardice. "As long as it comes from outside what is [perceived as] their choice—something imposed on them—it takes away the politically negative connotations," Michels commented. In this connection, it was proposed that protected leaders—at least the most visible of them—wear bullet-proof vests during public appearances. A more radical suggestion was that federal legislation be developed to limit the freedom of movement of protected leaders, the requirements of which would be imposed in such a way as to enable them to avoid the appearance of cowardliness. SUGGESTED APPROACHES TO THE STUDY OF ASSASSINATION Many types of violence and violent persons have been extensively studied and are well understood, but the phenomenon of assassination is not among them. In contrast to many other violent crimes, assassination occurs very rarely—at least in the United States—which means that there are few instances available for study. Infrequent, or low "base rate," events present special problems for those who would like to be able to predict their occurrence and design research to expand knowledge about the conditions under which they occur and the kinds of persons likely to be engaged in them. The infrequency of assassination, especially assassination of those protected by the Secret Service, is of course, both encouraging and highly desirable. At the same time, however, the low incidence of this behavior has made it very difficult for the *See also Saleem Shah's paper, page 121.

Secret Service to learn whether its own information-gathering activities and interventions with persons considered potentially dangerous are appropriately targeted and have any validity. As Alfred Blumstein pointed out, the Secret Service has had a great deal of experience with threats, threateners, and a variety of untoward behaviors presumed to be indicative of impending assassination attempts (if intervention is not forthcoming), but very little experience with assassination itself.* In both plenary and workshop sessions, conference participants and Secret Service representatives alike raised many questions about the characteristics and possible motivations of potential assassins, as represented by the caseload of subjects the Secret Service considers potentially dangerous to those it protects. John Monahan mentioned three frequently cited motivations for assassination: the desire to murder one's father through killing a symbolic father (in the person of the president, for instance), the desire to attain glory by killing of a famous person, and the desire to commit suicide in the process of killing another. Many had questions about victim selection: why one person is targeted for assassination rather than another. To what extent, participants wanted to know, are victims interchangeable? If a subject expresses a direction of interest toward one protected person (the president, for example), might that subject also be dangerous to other protected persons (the vice president or the president's wife, for instance)? In the same vein, if a subject expresses hostile intent toward a senator, governor, or mayor, is that subject also a risk to persons protected by the Secret Service? Similarly, if a subject threatens to harm a protected person, might that subject also, or alternatively, harm a Secret Service agent?** And if a subject is known to have had sinister intent toward a past president of the United States, should he or she also be considered a risk to the current president? Conferees also wondered whether persons with hostile intent toward non-political public figures might evidence similar hostility toward political leaders. For example, are people who threaten or harm celebrity figures likely to be dangerous toward persons the Secret Service protects? *For discussion of some methodological and substantive problems associated with low base rate behaviors, see presentations by James Billings, Don Gottfredson, Jenkins, and Monahan (pages 143, 139, 145, and 129, respectively); and memoranda by Jenkins, Monahan, and Zimring (pages 177, 179, and 183, respectively). **This concern was prompted by a Secret Service case presentation involving a subject who had expressed animosity toward protected persons and subsequently killed a Secret Service agent. 45

A somewhat different and more basic issue touched upon earlier was raised by Marvin Wolfgang, who wanted to know the relationship between threats and actions. Are those who have thus far done nothing more than threaten a protected person likely to follow through on their threats, or are threateners and actors two distinct groups? Speculating on the motivations of persons who engage in extortion threats with which he is familiar, Jenkins noted that four patterns have been identified: those for whom threatening itself is a form of gratification and constitutes expressive behavior, and who have no interest in carrying out their threats; those who hope, by threatening, to disrupt normal activities and create chaos; those who are interested in extorting money or goods, but not in carrying out the threatened activity; and those who have a genuine interest in carrying out the threatened activity itself and can not be bought off. In view of the many unknowns, conferees suggested that the Secret Service would benefit from empirical studies designed to increase its understanding of assassination, and thereby to improve its ability to detect those who may be truly dangerous to persons it protects. The following ideas for research were proposed, some of them as methods of expanding the number of cases available for study: Comparison of Dangerous and Never-Dangerous Cases On the assumption that the Secret Service itself is the best judge of the level of risk posed by subjects to persons it protects, several conferees suggested that a retrospective analysis and comparison of dangerous and never dangerous subjects in its files would probably be a good starting point for understanding the characteristics of potential assassins. Study of Behaviors Similar to Assassination Because assassination is so rare—at least in the United States—and the Secret Service caseload of subjects contains no one who has ever attempted it, several conferees suggested that the Service try to test the validity of its own decision-making with respect to dangerousness on a similar, or "proxy," behavior that occurs with some frequency among its caseload of subjects. The validity of agent predictions (dangerous or not dangerous) would be tested by examining the extent to which these predictions correctly distinguish subjects who do and do not subsequently engage in the proxy behavior. This idea was originally proposed by Franklin Zimring and is discussed in his memorandum circulated to conferees and included in 46

this report.* In that memorandum, Zimring suggested acts of personal violence toward strangers and suicide as possible "proxies" on which to test the validity of agent decision-making. Although neither of these was considered truly parallel to assassination, several conferees thought their incidence among Secret Service cases might be worth examining. Others, however, had reservations about the use of suicide as a proxy, even though an empirical connection between homicide and suicide has often been observed, and clinicians have noted similarities in the psychodynamics underlying both behaviors. James Billings, an expert in suicide research, did not support the use of suicide as a proxy for assassination, though he did think there were similar methodological problems in identifying likely candidates for each type of behavior.** Conferees also suspected that the incidence of suicide among cases on file with the Secret Service might be too low to yield valid results. Study of "Threshold" Behaviors of Secret Service Subjects Assassination and attempted assassination are rare, but there must be many Instances, as Charles Halpern observed, in which a Secret Service subject or other person has come very close to making an assassination attempt, but was deflected by Secret Service agents or others just as he or she was on the threshold of so doing.*** Halpern suggested that "threshold" behaviors—immediate preludes to assassination attempts—be carefully analyzed and described to better understand behavioral indicators of imminent danger and detect possible flaws in the Secret Service protective system. Such a study could be begun by asking special agents to recall their "near misses.1 Detailed Study of Assassins Walter Menninger suggested that a detailed study of all assassins and attempted assassins of political leaders, whether living or dead, should be undertaken. Such a study should include descriptive and clinical data on the personalities and backgrounds *See page 183. A member of the planning committee, Zimring was unable to attend the conference. Also relevant in this connection are memoranda by Gable and Monahan, pages 171 and 179, respectively. **See presentation by Billings, page 143. ***0ne such case was described by a Secret Service representative at a planning committee meeting prior to the conference. 47

of these persons, as well as the circumstances surrounding their attempted or successful assaults. Clinical Studies of Attackers of Prominent Persons To increase the number of cases available for scrutiny, several conferees suggested that persons who have attacked or attempted to attack prominent political figures other than, or in addition to, those protected by the Secret Service might be studied. Such targets could include elected leaders, such as senators, congressmen, governors, mayors; appointed officials; and/or prominent activists, such as civil rights leaders. Such a study might be limited to the United States, or might include attempted and successful assassins of foreign leaders in their own countries. Alternatively, or in addition, persons who have attacked or attempted to assault famous persons or celebrity figures other than political leaders might be studied. Edwin Megargee suggested that such a study might include an assessment of the personality patterns of those who engage in such behaviors and the skills required to carry them out. It might also be possible, as Wolfgang suggested, to examine the level and type of threat activity which preceded such attacks and compare those who have given prior notice with those who have not. Studies in Victim Provocation Sara Eddy suggested it might be useful to examine whether there is anything specific about political leaders themselves—their personalities, political style, the nature of their public statements, and so forth—which might elicit threats to their safety or assaults on their lives. She suggested that a sample of political leaders who have been threatened be compared with a sample who have never been threatened. In a similar vein, Elissa Benedek suggested that those presidents who have had the most threats on their lives be examined to see whether anything about their personalities, style, or behavior could be considered provocative to would-be assassins. 48

RELATIONSHIP BETWEEN THE SECRET SERVICE AND THE MENTAL HEALTH COMMUNITY Because approximately 90 percent of the subjects whom Secret Service special agents presently consider dangerous had been previously diagnosed as having mental or emotional disturbances, conferees explored current and possible future relationships between the Secret Service and mental health professionals. Based on pre-conference briefings by Secret Service personnel and conference discussion, many participants—especially psychiatrists and other clinicians—felt that the present relationship between the Secret Service and the mental health community is inadequate in magnitude and less than optimal in terms of overall quality. The Secret Service is not at present a fully informed consumer of mental health services. As with other topics of discussion, conferees stressed that implementation of their suggestions or ideas for improvements might result in incremental gains, but not in great improvements. They also hoped that the mental health aspects of the Secret Service assessment and management tasks would not deflect attention from other equally or perhaps more important aspects of Secret Service operations. Current Methods of Dealing with Mentally I11 Subjects Because so many of its dangerous subjects seem to have mental or emotional problems, the Secret Service itself acts as both a provider and consumer of mental health services. The Service provides mental health services to the extent that it operates as a kind of emergency mental health facility for disturbed subjects whose behavior is bizarre or otherwise apparently dangerous to protected persons and for whom it is unable to obtain assistance from mental health personnel and institutions. In these instances, Secret Service special agents must often "babysit" such subjects, try to help them, and otherwise take responsibility for monitoring their whereabouts until outside assistance can be enlisted, if at all. The Service acts as a consumer of mental health services to the extent that it (1) uses its few informal ad hoc relationships with various mental hospitals and clinicians for consultation about difficult cases, (2) facilitates hospital admissions for subjects it considers highly dangerous to protected persons, (3) monitors the progress of subjects based on information provided from hospital personnel, and (4) arranges follow-up psychiatric care for its non-institutionalized subjects. When mental Illness is suspected as the underlying cause of a subject's dangerous statements or behaviors, Secret Service agents 49

typically try to convince the subject to admit himself, on a voluntary basis, to a mental hospital for observation and evaluation. Agents often prefer this management route because it gets the subject off the street. As some conferees pointed out, however, voluntary admission is at best only a temporary solution, because the subject will typically be evaluated and released within 10 to 20 days, when he or she will again become the full responsibility of the Secret Service in its protective function.* Second, because the Secret Service has peace officer status in only eight states,** involuntary commitment (for apparently mentally ill subjects who refuse or are unable to admit themselves voluntarily) requires the active involvement and cooperation of local police, family members and/or psychiatrists, and is far from routine. (The decision to commit an individual for emergency observation is, of course, a medical one, and not a Secret Service function.) Additionally, though hospital personnel are asked and expected by the Secret Service to alert the Service when one of its subjects is about to be discharged, special agents have found they cannot rely on them to do so. Obstacles to Professional Relationship Both Secret Service representatives and conferees—particularly clinicians—felt that at present there are several obstacles to the establishment of mutually beneficial relationships between the Secret Service and the mental health community. These are rooted in conflicting values and differences in orientation, function, and professional training and experience. Differences in Values, Orientation, and Function Although Secret Service agents and mental health professionals may in many instances be dealing with the same person, or with similar populations (e.g., the mentally ill or emotionally disturbed), their professional orientation toward such clients or subjects will necessarily differ. For example, psychiatrists *See also Management of Dangerous Subjects, page 59. **The following is a generally accepted definition of the term "peace officer": "any person who, by virtue of his/her office or public employment, is vested by law with a duty to maintain public order or to make arrest for offenses while acting within the scope of his/her authority." The Secret Service has peace officer status in Alaska, Hawaii, Idaho, Kansas, Montana, Utah, Virginia, Wisconsin, and the District of Columbia. 50

are concerned primarily with treatment and establishing a therapeutic alliance with the patient, which is usually enhanced by the ethic of confidentiality and the privileged nature of most doctor-patient communications. The Secret Service, in contrast, must deal with subjects within the context of social control, law enforcement, and criminal justice, however much special agents may also be interested in promoting the personal welfare of such persons. To some extent, differences in values, orientation, and functions hinder the development of cooperative relationships between the Secret Service and the mental health community, as some members of each may have negative images of the other. For example, some psychiatrists view Secret Service agents as cops who practice deceit, and whose intervention may render successful treatment of their patients an impossibility. Many psychiatrists, in fact, would be reluctant to violate the confidential relationship they have with their patients in order to oblige Secret Service requests for information. Similarly, Secret Service agents may view psychiatrists and other mental health professionals as uncooperative and unnecessarily reticent about those of their patients who are, or could become, Secret Service subjects by virtue of threatening a protected person. Secret Service representatives also mentioned difficulties they have encountered in obtaining information from hospital records about subjects who have threatened protected persons or otherwise behaved in ways considered dangerous to them. In their view, concern with the rights of patients—and with civil liberties generally—has increased in the past few years, making their ability to carry out their protective duties much more difficult. As amply illustrated in both plenary and workshop discussions, each side also recognizes the danger of co-optation by the other, if the working relationships between the Secret Service and the mental health community were to be improved. The inadvisability and potential hazards of either side wearing two hats were extensively discussed. Basis for Mutually Beneficial Relationships Despite the gravity of the obstacles discussed above, many conferees felt that a framework for mutually productive relationships between the Secret Service and the mental health community could be developed. Adherence to the following precepts was considered essential to the establishment of successful relationships: • Ideally, there should be no role confusion or blurring of the distinction between the appropriate role of the Secret Service and that of the mental health professions. In John Lion's opinion, each group must recognize a "fundamental division . . . between 51

police types of work and clinical practitioner types of efforts." That is, Secret Service agents must at all times be realistically aware of their own goals (for instance, to do what they deem necessary to protect the president from potentially dangerous persons), while mental health professionals must similarly give their full allegiance to the credo of their professions (for example, to do what is in the best interest of the patient or client, from a therapeutic standpoint). In short, relationships between the Secret Service and the mental health community should be built on "cooperation without co-optation." • Neither the Secret Service nor the mental health community can delegate its own responsibilities to the other. The Secret Service, for instance, cannot assume that if it turns a subject over to the mental health system for evaluation, treatment, and/or monitoring, its responsibility for that subject in relation to its protective function has ended.* Secret Service agents should themselves be prepared to interview subjects in the hospital, if and when they are hospitalized. Likewise, mental health professionals cannot delegate medical decisions (for instance, determination as to whether a subject is committable to a hospital for observation) to Secret Service personnel. • To develop mutually satisfactory relationships between the Secret Service and the mental health community, each must learn more about what the other does, how it is done, and what each other's competencies and limitations are. • Such relationships as are developed should be based on the principle of collegiality. There should be less deference on the part of the Secret Service to the presumed expertise and superior wisdom of psychiatric opinion, for instance. Formal and Informal Relationships Conferees reached no conclusion as to whether relationships between the Secret Service and mental health practitioners and institutions should be kept informal (the way they are at present) or formalized into more permanent, standing arrangements whereby the Secret Service would contract for specific services from particular institutions and mental health professionals over a period of time. *The Secret Service does not presently delegate that responsibility, nor does it anticipate wanting or being able to do so. 52

John Lion argued against formalizing the relationships, because he feared that the mental health professionals and institutions involved would run a serious risk of co-optation by Secret Service goals and the professional integrity of the psychiatric community would thereby be compromised. A non-institutionalized ad hoc consultation process, he felt, would be much less likely to result in co-optation. Such an approach would mean that the Secret Service would consult various different practitioners or institutions on a one-time or infrequent basis, but not repeatedly over long periods of time. Several other conferees, however, noting the less than optimal quality of some of the advice and consultation the Secret Service presently receives and the inadequacies in patient care provided to some of its subjects, thought it would be advantageous to the Service to know and develop continuing relationships with specific mental health practitioners and institutional providers in the geographic areas where the largest numbers of dangerous subjects are typically found. Formal agreements or written understandings with competent professionals and institutions would improve the overall quality of the assistance the Secret Service receives in the mental health field. Joseph English suggested that liasons with specific teaching hospitals having a major psychiatric capacity would be a useful way of providing the Secret Service with first-rate advice and consultation. Some Proposals for Establishing Linkages Many different proposals or models for establishing productive relationships between the Secret Service and the mental health community were suggested by conferees. Each of the suggestions below would be one method by which the Service could enhance its capacity for decision-making with respect to its caseload of mentally or emotionally disturbed subjects. • The Secret Service might solicit the advice of psychiatrists when dealing with difficult or ambiguous cases, where there is some question as to the subject's diagnosis and prognosis, with implications for dangerousness to the protected person. • Rather than use the services of mental health consultants whose allegiance is external to the Service, the Secret Service could hire its own mental health experts or psychiatrists as staff members, whose role would be defined by the Service's mission. • The informal consulting relationship that has recently been developed between the Boston field office of the Secret Service and the McLean-Bridgewater Program of Belmont, Massachusetts, might serve as a prototype for the development of similar relationships elsewhere in the country. This cooperative arrangement enables Secret Service field office personnel to learn about psychiatric disorders and their S3

relationship to dangerousness, and to observe clinicians interviewing violent patients (with the informed consent of such patients).* • A nationwide network of local mental health resource centers could be developed to provide the Secret Service with consultation and advice in screening incoming cases for relevancy, assessing potentially dangerous subjects, and handling the disposition of cases. Consultants to such centers might include representatives from the criminal justice system, mental health professionals, civil libertarians, and others whose expertise and concerns are relevant to the Secret Service mission.** One Secret Service representative had reservations about this proposal because he felt it might involve unwarranted delegation of Secret Service authority and responsibilities to an outside reviewing body. Constraints on Mental Health Provider Capacities Although the Service could undoubtedly benefit from the advice and assistance of mental health professionals and institutions in the area of assessing and managing dangerous subjects, clinicians cautioned Secret Service representatives not to overestimate the capacity of the mental health system to respond. They emphasized that mental health facilities are undergoing major changes in underlying philosophy, staffing patterns, and funding, especially with respect to the chronically mentally ill, who are being sent back into their communities in great numbers. Cutbacks in institutional services to the chronically mentally ill are causing hardships for other institutions and organizations, as they try to absorb and provide services to this population that until recently was relatively confined. Some conferees noted that the Secret Service may in some measure be heir to the deinstitutionalization of the chronically mentally ill, as many of the Service's problem subjects (including repeat threateners) seem to come from this population. Because of such policy changes in the mental health field, clinicians told Secret Service representatives to expect that it will become increasingly difficult for the Service to have its subjects either committed to mental hospitals for observation and evaluation, or to gain long-term institutional care for subjects who are chronically mentally ill. Rather, the Service should be prepared to look to management alternatives other than long- or short-term commitment to mental hospitals. *For fuller details, see paper by Frazier and colleagues, page 93. **For fuller elaboration of this concept, see paper by Shervert Frazier and colleagues. 54

Legal and Ethical Issues in the Relationships There are many unresolved and thorny legal and ethical issues in the current and possible future relationships between the Secret Service and the mental health community. A number of these were raised or touched upon during the conference, but most are in need of further study and clarification, as discussed below. Issues of Confidentiality and Privacy To what extent do and should psychiatrists and other mental health professionals report to the Secret Service threats against protected persons which they might hear from patients? This issue was provocatively raised in a commissioned paper by Robert Michels, included in this volume.* In that paper, Michels asks why it is that there are so few referrals from the psychiatric community to the Secret Service. The legal and ethical issues involved here are complex and will not be readily resolved to the satisfaction of interested parties—principally psychiatrists, patients/subjects, and the Secret Service. Three points of law are involved. First, under federal statute 18 USC 871, the so-called "threat statute," it is a felony to make a threat against the president of the United States. Theoretically, anyone who witnesses such a threat is obligated to report it to the Secret Service; failure to do so constitutes misprision of a felony.** Second, the traditional confidentiality and privileged status of the doctor-patient relationship is often but variously codified in state law. As noted by Alan Stone, the extent to which such confidentiality is protected in practice is complicated by the fact that "different states treat the confidentiality of patients differently . . . ."*** The third is the "duty to protect" issue, sometimes referred to as the "duty to warn" stemming from civil law and its extention into the psychotherapist-patient relationship. This principle was preeminently highlighted in the 1976 California Supreme Court decision in Tarasoff v. Regents *See page 107. **Under Title 18, USC, Section 4, a misprision of a felony occurs when a person "having knowledge of the actual commission of a felony recognizable by a court of the United States, conceals and does not as soon as possible make known the same to some judge or other person in civil or military authority under the United States.' ***Memorandum from Alan A. Stone to Institute of Medicine staff, May 6, 1981. Dr. Stone, a member of the planning committee, was unable to attend the conference. 55

of the University of California, which stated, "When a therapist determines, or pursuant to the standards of his profession, should determine, that his patients presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger."* How much this ruling potentially undermines the therapeutic alliance between the doctor and patient and is in conflict with the confidentiality tradition is a matter of debate. One conferee, psychiatrist Frank Ochberg, observed, "We are in the business of serving the individual client and not the state, but we are beginning to be held somehow responsible, culpable, for the dangerous delusions of some of our patients." Stone contends that "the decision to protect the community and reveal confidences is clearly and obviously ethical. The failing of the ethical code is that it gives no guidance as to what degree of danger justifies the decision.** There has additionally been concern in the psychiatric community about liability for breaking confidence in order to protect or warn. Stone contends that although therapists may be "troubled" about breaking confidence, "the canons of ethics for psychiatry permit this and the reality seems to be that there would be little genuine risk of civil liability unless the therapist is quite irresponsible in evaluating the danger posed by his patient." If a patient were to sue, Stone maintains, "the legal claim must be that the therapist was negligent in diagnosing the patient as dangerous. That should be as difficult to prove as that the patient was not dangerous."*** Michels himself noted, in workshop, that there is no obligation to report distant threats. In all likelihood, most psychiatrists would base their reporting decisions on their own estimates of the patient's imminent dangerousness to a potential victim. Secret Service personnel say, however, that they themselves would like to be in a position to evaluate the seriousness of such threats (and the dangerousness of the threateners), and therefore would want to be informed when such threats occur. (The ethical aspect of this question is independent of the quality control consequences of a vastly increased Secret Service caseload that might result if such reporting became widespread.) How much, if any, information about a psychiatric patient who is also a Secret Service subject should be shared between mental health professionals and Secret Service personnel, and who should do *Tarasoff v. Regents of the University of California, 17 Cal. 3d at 431, 551 P.2d at 340, 131 Cal. Rptr. at 20. **Stone, op. cit. ***Stone, op. cit. 56

the sharing? Should there be some uniform practices or requirements concerning the sharing of information about a patient/subject between mental health professionals and institutions on the one hand and the Secret Service on the other? Secret Service personnel say they are hampered in their investigations by variations in state law as to their access to hospital records. If the Secret Service uses psychiatric consultants to assist in assessing and monitoring Secret Service subjects, would it be ethical for such consultants (a) to render judgments on subjects they have not personally interviewed, and/or (b) to consult about the subject with a psychiatrist who has first-hand knowledge about the subject, in order to advise the Secret Service concerning the subject's likely dangerousness or an appropriate monitoring strategy? That is, could and should a Secret Service psychiatric consultant render an opinion on a subject without having evaluated the subject? Issues of Professional Independence in Judgment The possibility that mental health professionals might be co-opted by Secret Service goals has already been mentioned as an issue some clinicians thought worthy of attention. The subject was broached most directly in the presentation by Joseph English.* Conferees emphasized, for instance, that decisions involving emergency admissions of persons to hospitals for psychiatric evaluation are legally and appropriately medical decisions, and not ones that should be made directly or indirectly by Secret Service personnel. The desire to be helpful to the Secret Service in its task of protecting government leaders should not overshadow professional medical judgment about admitting a subject to a hospital for evaluation. Some Suggestions for Study and Clarification R. K. Gable suggested, and others concurred, that the controversial legal and ethical issues in the relationship between the Secret Service and the mental health community should be clarified and guidelines for Secret Service procedures and conduct developed. Among these issues are: • confidentiality of information revealed in psychiatric interviews versus the obligation to protect a potential victim • liability of clinicians for errors of judgment with respect to Secret Service subjects *See page 155. 57

• legality of imposing certain requirements on mental patients as a condition of their release from hospitals, similar to probation requirements for persons released from prison (such as non- possession of firearms) . Gable also suggested that the Secret Service's manual of legal opinions and decisions be reviewed by mental health attorneys and mental health administrators. Robert Michels made the following suggestions: (1) that a dialogue among mental health professionals concerning the legal and ethical dilemmas in the relationship between the Secret Service and the mental health community be initiated; (2) that there be consideration of regulations and laws to protect from liability professionals who warn in good faith, analogous to the protection provided for the reporting of child abuse; (3) that policies be developed to assure that the Secret Service consider not only the "rights" of subjects, but also their "interests," in order to reassure mental health professionals that it is appropriate for them to warn when indicated; (4) that mental health professionals be made aware of the fact that a threat against the president is a felony and therefore the threshold for warning is different from what it might be for threats against other persons; and (5) that a procedure to collect and study warnings received from mental health professionals under the threat statute be established.* Two new federal statutes were also proposed, but neither was discussed in depth. Joseph English thought a federal commitment statute should replace the individual state commitment statutes, which are confusing in their non-uniformity with respect to commitment criteria. In connection with discussion of malpractice and hospital liability insurance, John Monahan suggested that a statute with the provision that the federal goverment assume liability for activities undertaken by a mental health professional in conjunction with the Secret Service might be useful. R. K. Gable suggested that the various state mental health statutes and regulations be reviewed and the most compatible ones used as the basis for developing draft (federal) statutes and regulations. Charles Halpern was opposed to the creation of any new statutes which would enhance the powers of the Secret Service. *Memorandum from Robert Michels to Institute of Medicine staff, June 1, 1981. 58

MANAGEMENT OF DANGEROUS SUBJECTS If a subject is determined by the Secret Service to be potentially dangerous to one or more protected persons, he or she is placed on "quarterly investigation." The quarterly investigation procedure involves reinterviewing the subject and/or others no later than three months from the time of the previous investigation, updating the information on file, and deciding again whether the subject is dangerous or not dangerous. In many instances, however, subjects considered dangerous are investigated and/or monitored more frequently. Each time a subject is evaluated as dangerous, he or she is scheduled for a quarterly investigation until such time as the agents decide he or she is no longer dangerous. Based on the findings of initial and subsequent investigations, decisions also are made about the disposition of the case. Examples of such dispositions include referring the subject to a hospital for psychiatric evaluation, attempting to prosecute the subject for violation of the threat statute, or allowing the subject to remain on the street while agents monitor his whereabouts and activities. Whether or not the disposition results in the subject's confinement, the three-month reevaluation requirement still holds. At any one time, 250 to 400 subjects are on quarterly investigation. The number of so-called QI's varies from day to day, as new cases are added and old (no longer dangerous) cases are. dropped. The size of the QI caseload at any particular time depends on many factors, and has been observed to vary with political conditions, national and international events, and the extent to which protected persons—particularly the president—are in the public eye. For instance, during the campaign period preceding a presidential election, and at the beginning of a new president's first term in office, the list is apt to be somewhat larger than normal. Actual assassination attempts on the life of a president also tend to be followed by an increase in the number of threats or other potentially dangerous activity, much of which comes from new subjects. Subjects particularly worrisome to the Service are those whose hostile interest in a protected person is high and intense, and who are not presently confined in a penal or mental institution. Secret Service concern about a subject is also heightened if he or she happens to live in the Washington, D. C., area (where a large number of protected persons are in residence), or when a protected person visits the subject's area of residence. In order to insure the safety of those it protects, the Service tries to minimize the opportunities for dangerous subjects to come in contact with protected persons, and does so by monitoring their whereabouts and status very carefully or, if appropriate, by resorting to the mental health or criminal justice system to secure their confinement. For instance, for subjects who seem mentally disturbed and have made 59

serious threats against a protected person, or who have behaved in other ways considered potentially dangerous to such persons, agents will often attempt to arrange their admission to a mental institution either voluntarily or involuntarily. For subjects who, by all indications, are not mentally ill but who, in the opinion of the Service, have violated the threat statute, special agents will often try for prosecution and incarceration under 18 USC 871. Intervention: Some General Considerations Conferees were in substantial agreement on the following points: 1. The goal of all intervention with subjects is to reduce the level of danger they present to protected persons. In that task, the Secret Service should use the least restrictive alternatives and benign interventions wherever possible. That is, the Service should try to discover and use the least damaging, least coercive, and least intrusive intervention measures consistent with the level of apparent danger posed by the subject. Adherence to this principle should preclude confrontations with subjects who may otherwise feel their civil rights have been violated. 2. Management options should be carefully examined and compared in terms of their effectiveness and cost. Alternatives that are sufficiently effective and least costly should be selected, provided they also meet the least restrictive criterion. Several conferees, for example, suggested that frequent telephone contact with subjects might be just as effective as an interview, and yet be far less costly. 3. Instruments used in reassessing QI subjects should be capable of yielding high quality information as to the subject's current mental and emotional status, level of interest in protected persons, and ability to carry out untoward acts. 4. Although the Secret Service seeks to control its subjects' violence potential toward protected persons, interventions need not have an adverse effect on subjects. In some cases they may well be therapeutic and thus of benefit to the subject as well as the protected person. 5. While there is no firm evidence that intervention with potentially dangerous subjects really is a deterrent to violence, the Secret Service cannot afford to test the effectiveness of its activities by suspending its interventions on a trial basis, because the risk of assassination is unacceptable. The most the Service can do is test the relative effectiveness of alternatiave intervention strategies. 60

Observations on Present Case Management Practices Descriptions of the quarterly investigation process and the dispositional strategies typically used by Secret Service agents led many conferees to conclude that the Service is at times insufficiently flexible to achieve its goals effectively and efficiently. More effective management strategies might eliminate the need for improving predictive accuracy—the extent to which dangerous and not dangerous decisions are the correct ones. Some conferees noted that present intervention strategies seem to be geared toward short-term rather than long-term solutions, with the result that subjects who are neutralized or otherwise effectively handled for the time being are likely to reappear as dangerous at some later date. For example, subjects temporarily incapacitated by virtue of having been sent to a hospital for a 48-hour psychiatric evaluation are likely to pose problems for the Service when discharged. In the opinion of several clinicians, management procedures should be tailored to meet the particular problems presented by each individual case, rather than standardized for use with all subjects. The task in monitoring or managing subjects, as in the management of psychiatric patients, is to determine "the optimal series of individual [management] decisions" for each subject, according to Robert Michels. Management strategies should also, of course, vary according to the anticipated proximity between a subject and his or her target. One method might be appropriate when a protected person is scheduled to visit a subject's area of residence, while another would be more useful when the subject is separated from the protected person by considerable physical distance. Similarly, monitoring strategies with subjects already confined should probably be different from those used with subjects on the street. For subjects who reside in areas where many protected individuals live (such as in the metropolitan Washington, D. C., area) still other tactics might be particularly appropriate. The Secret Service is, of course, sensitive to the need to vary its monitoring strategies in accordance with the situation and the particulars of the case, and in fact does so. Conferees simply wanted to encourage the Service to expand its efforts along these lines and to explore a broader range of tactics than it now uses. Some conferees questioned whether the current practice of dropping in on subjects in their homes on an unannounced basis for an interview is the most effective way to elicit the information needed. Alternative suggestions here were to conduct interviews in Secret Service field offices or to make appointments for interviews in subjects' homes. 61

In the opinion of several conferees, reevaluation or reassessment of a dangerous subject at periodic intervals should be undertaken not so much for the purpose of determining whether or not he or she is still dangerous, but rather to decide whether, in comparison with the last evaluation, the subject is becoming more or less dangerous. Two separate assessments are necessary here: a decision as to whether the subject's mental status is improving or worsening (requiring agents to be able to detect slight shifts in functioning), and a decision as to whether the subject is becoming more or less lethal (i.e., moving from verbal hostility toward hostile action, or vice versa). Agents should be aware that a short-term improvement in mental status does not necessarily imply that the subject poses less risk to protected persons. Case Management through the Criminal Justice System For subjects the Secret Service considers to be in violation of the threat statute (18 USC 871), special agents often attempt prosecution. However, the proportion of cases actually prosecuted (and convicted) under the statute is relatively low, apparently because many such threats are viewed by United States attorneys and the courts as constituting the legitimate exercise of free speech, or simply verbal hyperbole. Conferees noted this fact and did not explore it.* Case Management through the Mental Health System Case management of mentally disturbed or psychotic individuals with a history of violence, or who are considered potentially violent, was discussed by Menninger in his presentation (Part III, "Some Techniques for Managing Potentially Violent Individuals"), and by Shervert Frazier in his presentation on interviewing techniques to be used for assessing potentially dangerous subjects. As previously mentioned, when a subject's threats or dangerous behaviors are viewed as manifestations of mental or emotional illness, Secret Service agents typically feel more comfortable if they can get the subject admitted to a hospital for observation and evaluation, and/or for treatment. Most prefer a voluntary admission route, in which the subject enters of his or her own volition. This management device becomes especially attractive when a protected person is about to visit the subject's area of residence and the subject is acting in a bizarre or irrational manner and has expressed a high degree of interest in that protected person. *See presentation by R. K. Gable, page 169. 62

Management problems occur in instances in which a subject does not wish to be admitted for evaluation or treatment, and where he or she does not satisfy the criteria for involuntary commitment in the opinion of the admitting physician or the court. For this reason the Service usually tries to develop a working relationship with one or more sympathetic institutions and mental health professionals in each field office jurisdiction. Whatever the ethical dilemmas posed by this fact, clinicians pointed out that from a practical standpoint, Secret Service management problems are not solved by gaining the subject's admission to a hospital for observation and/or treatment. If the subject has voluntarily admitted himself to a hospital, he is free to leave at any time (although most states permit a delay in his release for a brief period if there is concern about his being dangerous). Because most hospitals have limited capacity for secure confinement, there is also the possibility that the patient will leave without authorization. Furthermore, overcrowding in mental hospitals, the trend toward deinstitutionalization of chronic mental patients, and liability issues often make admitting physicians reluctant to take on new potentially violent patients. In private hospitals, the subject's ability to pay the hospital charges or his access to third party reimbursement would also be a factor. These problems prompted some conferees to suggest that surveillance or other more intensive forms of street monitoring of such subjects might be more feasible, more reasonable, and more in keeping with the values of American society. The presentation by Joseph English illustrated many of the dilemmas that the needs and mandate of the Secret Service may pose to admitting physicians and their hospitals. On the one hand, some physicians may wish to oblige the Service by admitting for involuntary observation and/or treatment a subject the Service considers dangerous. However, the subject may not meet the criteria for admission in that particular state. In the state of New York, for example, where Joseph English is director of psychiatry for St. Vincent's Hospital in Manhattan, it must be shown that the person (a) has a mental illness and can benefit from treatment, and (b) that he is "imminently dangerous" to himself or others to justify an emergency involuntary admission to the psychiatric service. Secret Service Interventions and Deterrence The Secret Service at present has no way to test the effectiveness of its interventions with subjects, in part because numerically there are so few assassination attempts on the lives of those it protects, and in part because it cannot afford to take the risk of not intervening where it thinks it should. Many conferees felt that the very existence of the Secret Service, and publicity about its activities, probably deters some persons who might 63

otherwise be willing to risk an assassination attempt. Marvin Wolfgang, for instance, suggested that, because rational persons base their actions on their own perceptions as to the probability that they will be arrested, convicted, and/or imprisoned, the best overall strategy for the Secret Service is to cultivate the mystique of its own ubiquity. A highly visible and well-publicized Secret Service presence, he said, would probably be more effective as a deterrent than specific interventions undertaken with individual subjects. As far as Secret Service subjects are concerned, some conferees pointed out that the mere fact that a subject is under investigation—has been interviewed by the Secret Service, knows that he is under the Service's watchful eye, and is aware that his relatives or others familiar with him are being contacted about his activities and whereabouts—probably acts as a deterrent. On the other hand, Alfred Blumstein cautioned against assuming that a mentally disturbed individual responds to implicit or overt sanctions in the same way others might—especially if he does not value his own life. Publicity about the activities and mission of the Secret Service, and its potential intervention, were regarded by conferees as legitimate and important forms of deterrence. A possible experiment to test the effectiveness of increased publicity about the Secret Service and its activities in reducing the number of threats and threateners was suggested.* Specific Case Management Suggestions 1. For subjects who are not deemed committable, but are still in need of some sort of mental health intervention, R.K. Gable suggested referral to outpatient or private treatment by highly qualified mental health professionals. Therapy could consist of rerouting or eliminating the subject's direction of interest toward protected persons, by means of such behavior modification techniques as stimulus narrowing, systematic desensitization, and instruction in the management of anger.** 2. In Charles Halpern's opinion, much more attention should be devoted to developing management strategies for subjects who are not mentally ill—a small but consequential proportion of the current caseload of dangerous subjects. *See Promising Research Opportunities: Some Specific Suggestions, page 77. **See Gable's memorandum, page 171. 64

3. More active or frequent monitoring of dangerous subjects not presently confined might be in order. Such subjects are obviously more likely to present an imminent danger than equally hostile subjects who are confined to a mental or penal institution. Some conferees suggested that non-confined subjects, who typically constitute about half the caseload of dangerous subjects, might be monitored on a monthly rather than a three-month basis. 4. Conferees generally felt it would be useful for the Service to stratify and rank order the various management options it has, by level of intensity, intrusiveness, and potential severity of the consequences to the subject. For example, involuntary commitment to a mental or penal institution for threats or other behavior considered dangerous to a protected person would head the list in terms of severity of consequences for the subject. Voluntary admission to a mental hospital for observation would be a less severe management technique, but more intrusive than referring the subject for outpatient treatment, which in turn would be more intrusive than having a family member watch the subject. Conferees also strongly urged the Secret Service to develop criteria to be used in deciding when to use each intervention strategy. 5. Several conferees suggested that the Secret Service experiment with greater use of the telephone to replace or supplement the personal interview for follow-up purposes, especially in view of the escalating cost of travel from field offices to the homes of subjects. The possibility that as much, if not more, information about the status of a subject could be gained by means of frequent telephone contact should be seriously entertained and investigated. Elissa Benedek, however, was opposed to the substitution of telephone interviewing for face-to-face contact with a subject for evaluation purposes. Interviewing in the home is a valuable source of cues that cannot be obtained by telephone, she felt. The telephone is, in her opinion, appropriate for use with collateral sources of information. Postcards and other notification devices also were suggested as potentially useful methods of letting a subject know the Secret Service is still interested in him. 6. Instead of attempting to commit a dangerous subject to a mental hospital for observation during the visit of a protected person to the subject's area of residence, it might be both simpler and more beneficial to the subject to suggest that he or she take a short "vacation" during the time-limited exposure of the protected person. Saleem Shah, however, cautioned the Service to be careful not to unwittingly provide positive reinforcement that could encourage problem subjects to return to the Service for more benign interventions. 65

7. For mentally or emotionally disturbed subjects, the provision of out-patient psychotherapy might be a beneficial intervention, which would not infringe on subjects' civil liberties.* 8. Some conferees questioned the value of reinterviewing dangerous subjects at all, as part of the quarterly investigation process. Although it is important to know a subject's whereabouts, there are ways to obtain such information without interviewing the subject. Only if a protected person travels to the subject's area of residence would an interview be desirable. 9. In connection with managing mentally ill or emotionally disburbed subjects, Shah suggested that agents be able to utilize mental health crisis centers, which would be open on a 24-hour basis. 10. Robert Fein suggested that the Secret Service experiment with interviewing dangerous subjects in locations other than their homes. For instance, conducting the interviews in Secret Service field offices might be less stressful for the agents involved, and thus more productive in terms of information yielded. (The primary advantage of interviewing subjects in their homes is that agents are able to gather clues from observation of the subject's surroundings.) 11. R. K. Gable suggested that the release of subjects from hospitals be made conditional upon some follow-up activities that would assist the Service in monitoring them, such as travel restrictions, medication compliance (if medication was prescribed upon discharge), periodic notification of the Secret Service or the hospital as to their whereabouts, and so forth. The use of case managers for this purpose was suggested.** 12. The institution of a computer-assisted system for making decisions about when to monitor and how to manage dangerous subjects was suggested by more than one conferee, and is discussed in the paper by Frazier and colleagues. Such a system would be programmed to include all relevant information collected on each subject, would be periodically updated to reflect current status, and would indicate occasions or time periods when individual subjects should be reassessed or monitored more closely, in terms of their own individual psychology and behavioral cycles (and their possible interaction with external events). Such a system could enable monitoring of each subject at intervals uniquely appropriate to him or her, and not necessarily on a quarterly basis. *See paper by Michels, page 107. **See Gable's memorandum, page 171, for elaboration of this point. 66

13. Marguerite Warren suggested that special agents be matched to subjects in ways that would facilitate Secret Service management goals. Not every agent, she suggested, is ideally suited to work with every subject. Ethical Implications of Case Management Practices Conferees and Secret Service representatives alike expressed concerns about the ethical implications of current and proposed intervention strategies and management techniques for dangerous subjects. Several conferees thought the mere fact of being on QI might be a stigma for subjects, let alone the possible psychological damage and legal implications that could be associated with the various intervention strategies themselves. One dilemma raised by Secret Service representatives concerned whether contacting a subject's employer for monitoring purposes constitutes an infringement of privacy and an unwarranted intrusion with potential for great harm. The pros and cons of using relatives and friends to gain information about a subject's attitudes and whereabouts were also discussed. The question of whether the Secret Service ever uses informants and undercover agents for intelligence gathering activities on subjects was also raised. Secret Service representatives explained that covert investigative activities are rarely employed, but such techniques do have some advantages. They may, for instance, enable the Service to gain a more accurate reading on the attitudes and activities of an occasional subject it believes is not being truthful with them, while not stigmatizing the subject with overtly intrusive types of interventions. Secret Service consultant Lewis Goldberg said he would regard the use of covert intelligence gathering activities on subjects as reprehensible in a free society. These and other such dilemmas were not resolved during the conference.* Recurrent and Persistent Case Management Problems Conferees noted several circumstances that are likely to present intractable case management problems for the Secret Service. One, discussed earlier, is the easy availability of weapons in the United States. The problem of armed, irrational, and extremely disturbed persons was amply illustrated in one of the Secret Service case presentations, in which a subject discharged from a mental *See also Legal and Ethical Aspects of Investigative Activities and Interventions, page 68. 67

hospital (and supposedly en route to admit himself to another mental hospital) was able to procure a weapon with which he soon killed a Secret Service agent. A second problem, also noted earlier, is the trend toward deinstitutionalization of chronic mental patients, for whom there is at present virtually no organized aftercare.* This trend, in the opinion of those familiar with the problem, is likely to result in an increase in the Secret Service caseload, as well as an increase in subjects who are repeat or "recidivistic" threateners. A third problem, illustrated in another case presentation, concerns the dependency that may be created if the Secret Service becomes for some subjects "the best friend they've ever had," in the words of one representative. For persons with chronic or recurring mental problems, repeated threats may gain the attention of the Secret Service and the gratification that the subject is seeking. Ironically, such dependency is particularly likely to occur to the extent that Secret Service interventions are benign rather than intrusive, and offered by way of sympathetic help. While there is a deterrent purpose in maintaining supportive contact with a subject, and.attempting to neutralize, redirect, or refocus his or her direction of interest away from the protected persons, such supportive contact may, for some subjects, develop a level of attachment to the Service that will result in the subjects' provoking repeated monitoring contact. This constitutes a drain on resources of the Secret Service and is a problem not easily resolved, even if the Service utilizes mental health consultants. LEGAL AND ETHICAL ASPECTS OF INVESTIGATIVE ACTIVITIES AND INTERVENTIONS Conferees' observations and suggestions with respect to the legal and ethical aspects of Secret Service information gathering activities and interventions with potentially dangerous subjects are summarized below.** *See discussion of this problem under Relationship between the Secret Service and the Mental Health Community, page 49. **See also Relationship between the Secret Service and the Mental Health Community. 68

Balancing of Competing Values The Secret Service mandate to protect the lives of highly placed leaders inevitably involves it in conflict with constitutionally-protected rights of individual citizens. The Service is thus perennially faced with having to maintain a delicate balance between its own mission and the civil liberties of those whom it investigates and monitors. Virtually all its activities in assessing and managing behavior potentially dangerous to protected persons involve legal and ethical dilemmas, and run the risk of involving the Service in costly litigation. Conferees were sympathetic to these concerns and suggested some ways to begin clarifying and resolving them. Availability of Legal Advice for Special Agents Conferees advised that special agents assigned to intelligence gathering and monitoring duties should be thoroughly conversant with federal, state, and local statutes pertinent to their work. It is especially important, in the opinion of conferees, that agents be able to obtain expert legal advice at any time during the day or night in the handling of difficult cases. (Secret Service representatives assured conferees that such advice is indeed available to agents on a round-the-clock basis.) Conferees also suggested that the Service solicit legal advice and review in connection with (1) questionnaire construction and the wording of specific questions to be used with subjects, (2) the use to which information gathered from and about subjects is to be put, and (3) intervention strategies that might raise legal problems. Use of Least Restrictive Alternatives As previously noted, the rule of thumb to be applied when intervening with subjects considered dangerous to protected persons should be to use the least restrictive alternatives commensurate with the need to protect. Application of this principle might mean, for instance, seeking outpatient evaluation and treatment rather than voluntary or involuntary commitment to a mental hospital for a subject who has a mental disorder but who poses uncertain or little imminent danger to a protected person. In Charles Whitebread's opinion, it is especially important "to be sensitive to the civil liberties implications of the management of people labeled dangerous but whose conduct has not yet run afoul of the standards for the imposition of criminal sanction." Charles Halpern expressed similar concerns in noting that a significant number of Secret Service subjects have been neither formally 69

diagnosed as mentally ill nor convicted of any crime. He argued in general for "humility in intervention."* In Halpern's view, conferees did not sufficiently explore possibilities for less coercive and less intrusive intervention measures. On an optimistic note, Whitebread observed, "It is remarkable to me the number of thorny legal issues which have effectively been undercut or entirely eliminated by scientific innovation." In his view, technological solutions analogous to the use of metal detectors in airports might be developed to greatly enhance the safety of public leaders and minimally intrude upon individual civil liberties. A Standard of "Reasonableness" Legal experts maintained that from a judicial standpoint, Secret Service information gathering and interventions are likely to be evaluated and judged in terms of their "reasonableness" and the degree to which procedures and criteria used in making decisions about individual subjects are applied in standardized*and uniform ways, rather than in an arbitrary or capricious fashion. A program in which the least intrusive intervention measures commensurate with the need to protect government leaders have been consistently used should be judged reasonable. Likewise, a coherent "rationalized" program, in which the various management options have been fully elaborated and the bases for selecting particular alternatives for each case have been spelled out, should stand up in court. To assess the impact of its own interventions on subjects, Judge Wald suggested that the Secret Service might take a retrospective look into its records to see whether any of its management activities have had serious legal ramifications, or "legally cognizable negative effects," on the subject(s) involved. If so, such intervention strategies should probably be modified or discontinued. Clarification of Legal and Ethical Issues Several conferees and Secret Service representatives cited examples of situations that pose management dilemmas for special agents. For instance, there are subjects who have made no overt threats and who are not in violation of any law, but whom the Secret Service considers dangerous because of their high level of hostile interest in protected persons. As Loren Roth noted, such subjects *Presentations by attorneys Whitebread and Halpern, pages 167 and 159, respectively, are relevant here. 70

may regard surveillance by the Service as an unwarranted intrusion into their privacy. The same dilemma might arise if the Secret Service conducted a "massive screening of all the politically sensitive groups," in Roth's words. Walter Menninger reiterated the Service's concern as to whether it is appropriate to contact a subject's employer as a management technique. Secret Service representatives acknowledged the dilemmas posed by such situations, which are common. In view of the sensitivity of the legal and ethical dilemmas posed on a daily basis by many aspects of assessing and managing potentially dangerous subjects, several conferees recommended that the Secret Service seek clarification of several legal and ethical issues prior to adopting new policies or procedures. Included here would be confidentiality, privacy, free speech issues, and the myriad of federal and state laws and regulations concerning hospital commitment and other mental health issues.* IMPROVING AGENCY OPERATIONS: RESOURCE ALLOCATION AND MANAGEMENT ISSUES Conferees quickly discovered that to be of genuine assistance to the Secret Service, they needed to be better informed about its mission and functions, and about its policies, procedures, capabilities, and deployment of resources (both monetary and staff). They felt that uninformed suggestions would be useless at best, and could even be harmful. Secret Service representatives emphasized that the Service is primarily action-oriented and that staff members do not spend much time evaluating how well they are doing and analyzing how they might improve their operations. Resources are distributed among tasks largely on the basis of tradition, and standard operating procedures are often based on historical precedent. Conferees were impressed with the wealth of data that is on file and potentially available for analysis, but how little has been done with it to discover more efficient and effective ways of doing things. To gain some understanding of Secret Service operations, conferees asked Secret Service representatives many questions about the allocation of time and other resources to various tasks, the *See presentations by Michels and Gable, pages 163 and 169, respectively, and paper by Michels, page 107. 71

rationale for various procedures, and many aspects of the caseload of dangerous and not dangerous subjects. For instance, some conferees wanted to know how man-hours are allocated between threat assessment and direct protection. Others were curious as to whether the size of the dangerous caseload is "management-driven" or "dangerousness-driven," in Robert Michels" words. Loren Roth and others, as noted earlier, wanted to know why subjects must be judged to be either dangerous or not dangerous, a dichotomy felt to be both arbitrary and irrelevant. Alfred Blumstein and Frank Ochberg wanted to know how a budget cut or increase would affect the operations of the Intelligence Division. If the budget were doubled, would the Service double its caseload of dangerous subjects from 300 to 600, or would it monitor the present 300 more intensively? If the budget were halved, would the Division continue to monitor 300 dangerous subjects less thoroughly, or cut the load in half? From what they were able to learn in the short time available, conferees suggested that the Service devote some consideration to the following topics: Characteristics of Cases and Caseload: Dangerous and Not Dangerous Subjects Because of its action orientation, the Service has devoted relatively little time and financial resources to analyzing its case files of dangerous and never dangerous subjects. The Secret Service does not have at its fingertips, and cannot now easily retrieve, for instance, fundamental descriptive data about all cases and about various categories of cases: their socioeconomic and demographic characteristics, frequency of threat activity, mental status, and so forth. Neither does it have readily available information about average length of stay on quarterly investigation for dangerous subjects, reintroduction rates, frequency and intensity of monitoring, and other caseload characteristics. Conferees felt it essential that the Service begin to track such information in order to gain a better understanding of the validity of its own view of dangerousness and to facilitate research on the usefulness of the data it collects and its various assessment and monitoring activities. Case Referral System and Intake Process As mentioned earlier, many conferees questioned the comprehensiveness of the case referral network and the administrative efficiency with which cases are referred to the Secret Service from government agencies and other sources. In general, conferees felt the Service should devote more time to case finding than it presently 72

does. They were not convinced that incoming referrals represent the full range of persons or groups that might be dangerous to protected persons. Such referrals, they suggested, are probably too heavily biased toward the mentally disturbed, some of whom may be less lethal than persons who are not mentally ill. Further, they consist mainly of "announced" threateners—persons who have had, in the opinion of some conferees, the poor judgment to have disclosed their hostility beforehand. In contrast, persons or groups capable of planning and carefully plotting an attack, and having the good sense to keep their intentions to themselves, might be able to evade the referral network. Conferees suggested, therefore, that the Service assume a more active role in identifying sources of danger it might have overlooked, and redirect some of its funds accordingly. Conferees also noted the opportunity for slippage in the inter-agency communication and referral process—a possible source of serious error—and suggested the Service re-evaluate its inter-agency communication system. Several conferees—most notably Robert Michels—suggested that the intake process, by which incoming cases are screened prior to deployment for investigation, should be re-evaluated. It was Michels' opinion that cases may have to be screened more carefully in order to prevent the system from being clogged with an extraordinarily high number of false positives. Michels suggested that a new short form assessment protocol be developed to screen for relevance prior to a full blown investigation of each referral (which current procedures require). Local consultants with appropriate expertise might be used to screen incoming cases. Operations Research: Development of a Management Information System Fundamental to any improvement in Secret Service operations is the development of an adequate management information system, which would make research on agency operations possible.* Conferees were unanimously agreed that the voluminous data on file about individual subjects, as well as the wealth of experience accumulated by seasoned agents, should be systematically extracted and computerized for research and analytic purposes. Such data, if made available in readily usable form, should help the Service critically examine its own operations and procedures, and ultimately gain a better understanding of the validity of its activities. *The present management information system is used primarily to identify threateners and to locate subjects for advance work prior to the arrival of protected person to their areas of residence. 73

The Legislative Mandate: Some Problems Saleem Shah questioned the rationale behind the list of persons Congress has mandated the Secret Service to protect. In his opinion, Secret Service resources that might profitably be used elsewhere are distracted by the duty to protect persons who are neither in the public eye nor in any particular danger as to their safety. Secret Service representatives acknowledged that the need to protect persons who face no greater risk than that of the ordinary citizen consigns some agents to duties they find boring and irrelevant. Alternative strategies for expressing concern for the welfare of such individuals are discussed by Shah in his paper. GUIDELINES FOR ESTABLISHING A RESEARCH AND CONSULTATION CAPACITY IN THE BEHAVIORAL SCIENCES AND CLINICAL DISCIPLINES In both plenary and small group sessions, conferees devoted considerable attention to the question, "How can the Secret Service become a more informed consumer of behavioral research?," initially posed by the Secret Service to the planning committee preparing for this conference. There was unanimous agreement, among conferees and Secret Service representatives alike, that the Intelligence Division should develop a research and consultation capacity in the behavioral sciences and clinical disciplines relevant to its mission. At present, the Division has neither the staff capability to carry out its own research, nor the capacity to evaluate incoming research proposals. It has only one staff member with research listed among his many other duties. The Service has contracted for behavioral research in the past, but its experiences with contractors have often been less than satisfactory, in part because it has lacked the internal capacity to define and evaluate desired research products. As pointed out by Don Gottfredson, Saleem Shah, and others, unless the Intelligence Division builds some research capability into its operations, it will be unable to use its very considerable wealth of information on file and the experiences and expertise of its special agents, to learn what works and what doesn't work and to improve its own operations. It was the opinion of all present that now is the time for such reflection, analysis, and evaluation to begin. Developing a Research Capability Although there was agreement on the need for the Service to develop a behavioral science research capacity, conferees differed 74

somewhat as to the ways in which a quality research program should be achieved. Much of their disagreement was about the most appropriate locus for such capacity-building to begin. As Robert Michels noted, the best science in the shortrun will be done outside the Service by contract, but the greatest impact on Secret Service operations will come from the development of a staff research capability. Several conferees, most notably Alfred Blumstein, argued that the first step in building such a research capacity should be to establish a research advisory board, external to the Service, which would oversee its development. In his opinion, it would be next to impossible at present for the Secret Service, a small federal agency, to attract as employees persons with the level of research competence and skill that would best serve its needs. Until it became sizable, any research unit established within the Service would be of low quality, according to Blumstein. Brian Jenkins, like Blumstein, also saw advantages in the creation of an ad hoc research advisory group. He proposed that such a group use the suggestions of this report as a starting point and assist the Service in (1) determining the nature, size, and direction of a possible behavioral science research program; (2) deciding what proportion of the research effort should be handled by staff and what proportion extramurally through contracts or grants; (3) determining staffing needs and staff composition; and (4) defining the nature of any long- and short-term contractual agreements the Service might enter into. In contrast, Billings, English, Gottfredson, and Shah all argued for development of a staff research capacity from the start. Billings pointed out that for an advisory group to have a sufficient influence on an agency, there must be "educated consumers within-house." Shah said that an agency that has operating responsibilities cannot afford to delegate to outsiders research related to the exercise of those responsibilities. In Shah's opinion, therefore, the Secret Service must from the start have at least the nucleus of its own research staff, to be further developed over time. If an outside advisory group were created, a research staff would be needed in order to put its recommendations into practice and to provide a link to senior management personnel. The functions of a research staff would also include deciding what research suggestions of the advisory group are worth pursuing, evaluating proposals, and translating research results and findings into operationally useful information. These two viewpoints were fairly readily combined in a consensus that both staff and advisory research initiatives should be undertaken simultaneously. An advisory group, working with a skeleton research staff would probably best suit the needs of the Service at present. The research advisory group might have some or all of these characteristics and functions: 75

• it would consist of a panel of behavioral science experts drawn from several different disciplines, similar to but smaller than the panel of scientists, scholars and clinicians assembled for this conference • its members might spend some time on site at Secret Service headquarters or field offices familiarizing themselves with Service policies and procedures, so that their suggestions would be practically relevant to ongoing activities • it would be an ad hoc organization, in existence only on an interim basis, until such time as the Secret Service itself was prepared to take over its functions • its main goals would be to assist the Secret Service in developing its own capacity to define its research needs, gaining entree to the behavioral science research community, exploring relationships with other federal agencies conducting relevant research, beginning to develop a coherent research program, procuring and evaluating behavioral science research, and developing its own research staff • it could provide direction to the Service in implementing some suggestions of conferees, such as developing a management information system useful for evaluating the effectiveness of its own activities and operations, descriptively analyzing and profiling its dangerous and not dangerous subjects, and commissioning specific research studies • it could stimulate research by behavioral scientists in the academic and private sectors on issues of concern to the Secret Service. Use of Behavioral Science and Clinical Consultants Conferees were unanimously agreed that the use of behavioral science and clinical experts as regular consultants should be encouraged as a means of obtaining advice in areas of specific need. They noted that the Service would always value a working relationship with individual consultants of its own choosing. Most conferees thought the Service was in a good position to exercise its own judgment as to the usefulness of particular consultants. Roth again cautioned, however, that for consultation to be truly useful, the consultants may need to immerse themselves in the day-to-day activities of the Service—to see how decisions are made, how interviews are conducted, how cases are referred for investigation, and so forth. Speaking for himself, Roth said that after such immersion he might "be in a better position to understand the 76

relevancy of what I know to ... what they have to do." Without such detailed understanding of how the Secret Service operates, he felt, consultants might make "deadly blunders" in their naivete. PROMISING RESEARCH OPPORTUNITIES: SPECIFIC SUGGESTIONS Numerous ideas and suggestions for research projects were offered during the conference. Many of these are discussed under other headings of this report. Some conference presentations, papers, and memoranda also discuss specific research proposals. The following is a synopsis of suggestions that emerged during plenary and workshop sessions, and that are not fully discussed elsewhere in this report. Conferees were emphatic that research and experiments to test the validity and usefulness of Intelligence Division activities are indispensable for improving the effectiveness and efficiency of the Division's operations. Although research may be viewed as a luxury which an operating agency can ill afford, without it there can be no genuine progress in understanding and fully "rationalizing" decision-making processes, procedures, and policies. In the words of Saleem Shah, the mere accumulation of experience without appropriate feedback and research is like "throwing darts at a dart board . . . in a darkened room."* High Priority Research-Related Tasks Conferees were in near unanimous agreement that three tasks to facilitate future research should be undertaken promptly: a retrospective descriptive analysis of file data on dangerous (and, if time permits, never dangerous) subjects; development of behavioral indices and scales to measure more precisely the level of danger posed by subject behaviors; and the creation of a management information system aimed at systematically improving operations. The accomplishment of these tasks should provide the Intelligence Division with a rudimentary capacity and data base of information for testing hypotheses and conducting studies it might wish to undertake in the future. *The importance and usefulness of experimental studies, and some possible Secret Service applications, are discussed by Lincoln Moses in his paper, page 113. A member of the planning committee, Dr. Moses was unable to attend the conference. 77

Descriptive Analysis of Subject Files Conferees felt hampered in their efforts to provide useful advice by the lack of descriptive information about Secret Service subjects as a group and various segments of the dangerous and never dangerous caseload—their socioeconomic, demographic, and psychological and personality characteristics; mental status and history; criminal history; types and frequency of threat activity or other dangerous behavior, and so forth. With the exception of Hillel Einhorn and Kenneth Hammond (for reasons discussed below), all conferees agreed that as its first and highest research priority the Intelligence Division should develop a descriptive summary of the characteristics of its dangerous subjects (and also its never dangerous subjects, if time permits). In order to do this, variables or data items of interest must be specified, extracted from the file data on each case (or a sample of cases), processed for computer use, and analyzed. Analysis of such descriptive data, for instance, might yield a better understanding of what factors—at least in the minds of Secret Service special agents—differentiate dangerous from never dangerous subjects, and assist the Service in evaluating the validity of agent decisions. In any case, availability of relevant data about subjects in computerized form could provide a starting point for empirical research to test a variety of hypotheses. Einhorn and Hammond were not optimistic that retrospective analysis of file data would be a productive undertaking. The very fact that the Secret Service has intervened in the lives of its subjects influences their subsequent behaviors, in many cases probably changing the outcomes or behaviors that might have been observed had no such interventions taken place. This problem of treatment effects would invalidate any study of agent decision-making that compared outcomes or subsequent behaviors of subjects classified as dangerous and never dangerous. Measurement Improvement Many conferees felt that to facilitate research and evaluation of agent predictions, revised assessment and management instruments should contain many scaled items, which would enable a subject's behaviors and activities to be rated in terms of their potential danger to protected persons. For instance, a scale of undesirable events, or threshold behaviors, short of an attempted assassination—a very rare event—might be developed for this purpose. Such undesirable and potentially dangerous behaviors might 78

include appearing in proximity to a protected person with a weapon, or plotting the movements of a protected person on maps from one's home.* Expanding the Management Information System to Support Operations Research The Intelligence Division uses its present management information system primarily to assist in the identification of threats and threateners, and to locate subjects during advance work prior to visits of protected persons to their areas of residence. The system is not now designed for research in support of modifying and improving operating procedures. Many conferees felt that the Service could benefit from the development of a management information system programmed for retrieval of such items as the rate at which cases are added to and deleted from the system, the average length of time or number of quarters a subject is consecutively classified as dangerous, the rate at which closed (not presently dangerous) cases are re-opened (newly classified as dangerous) for investigation, the amount of agent time spent in different aspects of assessing and managing subjects, and so forth. Analysis of such data on a periodic basis would aid the Service in discovering which of its operations are too time-consuming or inefficient in terms of the benefits yielded, and other matters pertinent to the effective and efficient operation of the Division. Other Research Suggested Testing Alternative Management Methods Several conferees pointed out opportunities for experiments that could be developed to test the feasibility and usefulness of different assessment or management strategies and procedures. Such experiments might be conducted by giving half the experimental cases one treatment, the other half another treatment, and then later comparing the groups on the basis of pre-designated outcome measures. Examples of such experiments include testing the effectiveness and efficiency of • telephone contact compared with personal interviewing for follow-up investigations of "dangerous" subjects • quarterly investigation and monthly investigation of "dangerous" subjects *See Assessing Potentially Dangerous Behavior, page 24. 79

• field office interviewing and at-home interviewing of subjects • male-female teams of interviewers and male-only interviewing teams (tested separately with male and female subjects). Conferees attached one proviso to all such experiments: there must be no diminution in the present level or intensity of subject monitoring, in view of the unacceptability of an untoward event, such as an assassination attempt. That is, the Service cannot afford to experimentally decrease or eliminate its monitoring activities, but can only vary in the way such monitoring activities might be carried out. Testing the Deterrent Effects of Publicity Although the Service cannot afford the risk of not intervening with subjects it considers dangerous, there may be other, indirect, ways to test the capacity of the Secret Service to deter behavior potentially dangerous to those it protects. One suggestion was to compare the volume of threats in a city where local Secret Service activities are highly publicized in the news media with the level of threat activity in a comparable (matched) city where the Service's activities are less well publicized. Prospective Studies Using Revised Data Collection Instruments Even though some conferees were skeptical about retrospective analyses of existing file data, there was a broad consensus that valid prospective experimental studies could be designed for use with new subjects, once the data collection instruments were revised and fully computerized.* Studies of Agent Decision-Making At present, agent decision-making with respect to the determination of dangerousness is intuitive and not very well understood either by the agents making those decisions or by their supervisors. Many conferees thought that more attention should be devoted to determining how agents actually reach their decisions. (One study on agent decision-making is in progress, as noted earlier.) The various agent decision-making patterns that emerge should be explicitly described and evaluated, and, if relevant, the better patterns used for training purposes. *See Assessing Potentially Dangerous Behavior, page 24, for a discussion of proposed instrument revisions. 80

Inter-agent reliability studies would also be helpful, in the opinion of several conferees. That is, once the criteria for decision-making with respect to dangerousness have been made explicit, agents could be compared in terms of their ability to reach appropriate decisions based on the criteria specified. Agents found to be less reliable than others in the quality of their decision-making could receive additional training or be reassigned to other duties. Testing the Effectiveness of the System Because the Secret Service has limited experience with actual assassination, it does not have secure knowledge that its information gathering activities, interventions with subjects, and protective measures are effective in preventing or deterring attempts on the lives of those it protects. Further, an adverse event—whether an attempted or successful assassination—creates severe morale problems for Secret Service employees, whether or not the Service can in any way be faulted for neglect of duty. Clinicians pointed out that Secret Service agents contemplating a possible assassination are in a situation analogous to psychiatrists facing the possibility that one of their patients may commit suicide (also an infrequent but highly perturbing act). Clinicians and behavioral scientists encouraged the Secret Service to confront squarely their fear of negligence, retrospectively analyze failures, and to anticipate and prepare for possible errors through a variety of research and training activities. The first two suggestions below are for scenario construction studies with training implications, proposed by Hillel Einhorn as ways for Secret Service employees to critically examine their operations and detect potential flaws or loopholes in their information gathering, subject management, and protective activities against assassination. Fault-tree analysis is a method of examining how large systems break down. Every conceivable scenario by which a protected person could be assassinated would be run through the Secret Service defensive-protective system to determine whether any routes to assassination are potentially available. Simulating an assassination assumes a rational-actor model of behavior—that a person will act rationally and logically to pursue his goal, however crazy or ill-advised that goal might seem. For instance, such a rational actor might start with the notion or delusion that the president of the United States is a tool of creatures from outer space and must therefore be forcibly removed from office and killed. Given this information, the agents' task 81

would be to determine how such a person might go about trying to assassinate the president. The various possibilities would be rehearsed in order to detect the system's weak spots, which might permit him to succeed. Other suggested studies include a test of the adequacy of the inter-agency case referral system, employing fabricated letters or actors to find out whether cases are regularly and consistently referred to the Secret Service (for instance, from the White House mail room or various government agencies) in accordance with guidelines issued. CAREER PATTERNS AND SELECTION OF SPECIAL AGENTS Career Patterns The Service's present policy is that recruits should be generalists for the first six years of their Service careers, rotating through several tours of duty and learning something about many different functions, but not becoming an expert in any of them. Many conferees, especially the clinicians, wondered about the wisdom and advisability of the Secret Service's preference for generalists over specialists among its special agents.* The Service's position derives in part from the belief that knowledge and experience gained in each rotation contributes to overall agent effectiveness, and will be a valuable asset in future assignments. While this view may be rooted in habit and tradition, rather than in a detailed and current examination of needs, the Service has a pragmatic reason for favoring generalists over specialists: in many of the smaller field offices to which special agents will be assigned during their careers, the entire Secret Service operation is not big enough to warrant specialists in different kinds of work. In accordance with the need for individuals who can perform a variety of Secret Service functions, the promotional opportunities for generalists are far better than they are for specialists throughout the Service. (As a rule, special agents advance within the Service by proving themselves to be good at everything.) In response to questions from conferees, Secret Service representatives acknowledged that many special agents do not enjoy the interviewing and investigative work connected with assessing and managing potentially dangerous subjects. Some, for instance, find *See also paper by Michels, page 107. 82

the interviewing distasteful or inherently stressful and/or the investigative work useless or boring. These agents often prefer other assignments, such as counterfeit detection, protective detail (physical protection), or the more conventional police types of work. Conferees were sympathetic to this problem—especially those whose experience with dangerous patients has made them familiar with the stress of dealing with potentially violent individuals over long periods of time. They also understood that having to generate apparently purposeless paperwork—in view of the infrequency of assassination attempts—can lead to discouragement and disillusionment. On the other hand, Secret Service representatives noted that there are some agents who thrive on the kind of work involved in assessing and managing subjects, and seem to be skilled and talented at interviewing and other aspects of the job. Conferees wondered whether such agents might be identified early in their careers (or even selected for the Secret Service on the basis of their interest and capabilities in these areas), encouraged to develop their potential along these lines, and permitted to be specialists rather than generalists. In this connection, some conferees challenged the Service preference for generalists. Marguerite Warren, for instance, noted that her experience with juvenile offender programs has led her to conclude—and there is evidence in the literature to suggest—that some individuals are less suited to performing a wide variety of different and unrelated tasks. In her opinion, such persons should be permitted to develop their preferred skills or native abilities to the maximum, and be assigned only to those tasks which they do best and/or prefer. She contended that-if there are agents who are particularly astute in diagnosing dangerousness on the basis of interviews with subjects, and others who are good at records investigation or case management tasks, the Service should consider splitting these functions traditionally handled by one agent (or two, acting as a team), thus permitting several agents to be involved in different aspects of the same case. In keeping with the view that there may very well be a place for specialists in the field of assessing and managing potentially dangerous subjects, conferees felt that promotional opportunities and meaningful career ladders should be developed for recruits who demonstrate capability in these areas, noting that persons who are excellent candidates for such work might not survive the years of varied assignments required before an agent has the opportunity to select a few areas for concentration. Further, in Robert Fein's opinion, special efforts must be made to retain and reward agents who have already worked their way up the ladder and are particularly adept at interviewing or other assessment and management tasks; theirs is a valuable skill which should not be lost through inadvertent and/or unjustifiable Secret Service policy. 83

Agent Recruitment and Selection Many of the suggestions for improved functioning of the Secret Service Intelligence Division have implications for recruitment and selection of special agents who will work in the area of assessing and managing potentially dangerous subjects. Although agent recruitment and selection were aired less fully than other issues, conferees did have a few observations on these topics, which are discussed below. Broadening the Applicant Pool Special agents at present are overwhelmingly white, middle class, and male. Although precise figures were not available, Secret Service representatives did indicate that the caseload of subjects with whom such agents typically come in contact includes both females and members of minority groups (especially blacks and hispanics). To facilitate communication between agents and subjects, who are likely to be of the opposite sex or of a different racial/ethnic background, conferees suggested that the Service make a concerted effort to recruit both women and minorities as special agents. While there is as yet no solid evidence that matching agents to subjects on the basis of sex and race/ethnicity would increase the relevance or validity of the information elicited for decision-making, experienced clinicians and behavioral science researchers have found that the sex and race/ethnicity of the parties involved in an interview often does make a difference.* Experiments to test whether matching by sex, race, and ethnicity affect the relevance or validity of the information elicited from subjects could, of course, be designed. Agent Selection: Desirable Incoming Qualifications and Skills Whatever their subsequent career patterns (generalist or specialist), incoming special agents who at any time will be assessing or managing potentially dangerous subjects should possess some basic qualifications and skills at the time they join the Service. Incoming special agents should be able to communicate clearly in English. Writing skills are especially important, as agents spend a great deal of time writing reports for use by others. Agents should also be able to observe and report accurately on what they see and hear during an interview with a subject, members of his family or employer, or anyone else who might be interviewed in connection with an initial or follow-up investigation. *See Frazier's presentation and paper by Frazier and colleagues, pages 133 and 93, respectively. 84

Whether an incoming special agent should be a skilled interviewer upon entering the Secret Service will depend upon the career pattern he or she will follow—specialist or generalist. For agents who will specialize in assessing and managing potentially dangerous subjects, demonstrated interviewing skills probably should be among the incoming qualifications. Conferees generally supported Kenneth Hammond's contention that potential recruits are unlikely to differ substantially in their decision-making and prediction capabilities, and thus should not be selected on grounds of apparent superiority in these areas. As far as other skills and abilitites relevant to assessing and managing potentially dangerous subjects are concerned, Robert Michels said that it is easier to select persons who already demonstrate capabilities in some of these areas than to train those without them—especially such qualities as interpersonal sensitivity, empathy, and "psychological mindedness."* TRAINING OF SPECIAL AGENTS Desirable Skills and Substantive Competencies Interviewing and Observation Skills Unless they enter the Service with fundamental skills and experience in interviewing both normal and mentally disturbed persons, special agents must be trained in basic interviewing techniques and in special techniques to be used with mentally ill and potentially violent subjects. Similarly, agents must develop their powers of observation, use them to gain information about subjects, and report accurately on what they have observed.** Ability to Detect Sources of Error in Judgment Einhorn suggested, and others concurred, that special agents should be trained to recognize common sources of error or invalidity in judgment and decision-making, and to be on guard against them in their own work. (The Service has already begun to incorporate this topic into its training program.) For instance, they should understand that because assassination is a statistically rare event *See paper by Michels, page 107. **Presentations by Frazier and Menninger are relevant here (pages 133 and 147, respectively), as is the paper by Frazier and colleagues (page 93). 85

in the United States, most of the subjects they classify as "dangerous" who are also mentally ill and have a history of violence would not attempt to assassinate a protected person, even if left to their own devices. Knowledge of Statutory and Case Law Judge Wald and other lawyers emphasized that agents must be thoroughly grounded in federal and state statutes and case law relevant to their work. Substantive Knowledge in the Area of Mental Health Conferees agreed that special agents should receive more training in the area of mental health than they now do, because of the high proportion of dangerous cases in which mental or emotional disorder is apparently present. Conferees discussed not only the positive contributions of a training program in mental health, but also its limitations—what it cannot and should not aspire to do. A mental health training program should not, for example, attempt to make psychiatrists out of special agents; nor should it overwhelm them with jargon and psychiatric nomenclature. Likewise, therapeutic and criminal justice goals and roles should be recognized as distinct from each other, and no attempt should be made to divert special agents from their foremost duty to function as law enforcement officials and guardians of the safety of protected persons. Many conferees considered the agents themselves to be the experts in judging dangerousness to protected persons, and thought they should not have their decisions unduly affected by the views of mental health professionals. Conferees substantially agreed that special agents who assess and manage potentially dangerous subjects need more extensive and detailed training in psychopathology and in the use of clinical management techniques and options. Present training activities of most special agents in these areas are superficial and do not systematically expose agents to a wide range of mental and emotional disorders and a versatile repertoire of techniques appropriate for managing dangerous subjects. Special agents rely too heavily on the mental health and criminal justice system for case disposition, in the opinion of some conferees. A mental health training program should include instruction in monitoring techniques and options which agents themselves can use, without resorting to the mental health or criminal justice systems. Agents also should understand the uses and 86

effects of medications frequently prescribed for mentally or emotionally disturbed patients. They should be taught how patients/subjects released from mental hospitals on medication are or should be monitored for medication compliance, whether by mental health personnel or by Secret Service agents acting or assisting as case managers.* Developing Skills of Agents Role Play and Use of Videotape Recorders The Secret Service Office of Training uses role play and videotape recorders for initial and follow-up training of special agents assigned to assessing and managing potentially dangerous subjects. Conferees considered these to be valuable instructional aids for teaching and refining interviewing techniques and for developing agents' self-confidence in interview settings. Both role playing and videotaping can improve performance by providing feedback under safe conditions (in contrast to the often stressful conditions under which actual interviews with subjects take place). Either method might help special agents learn how to ask appropriate follow-up questions to elicit relevant information not volunteered by a subject. Nevertheless, conferees also emphasized that there is no substitute for exposure to and experience with live cases during training. That is,,experience with psychiatric patients and others (whether mentally disturbed or not) who are or resemble subjects potentially dangerous to those the Secret Service protects is an indispensable component of any such training program.** Internship in a Clinical Setting In the opinion of several clinicians, an effective way to expose special agents to patients and at the same time familiarize them with a wide range of clinical disorders and mental health issues would be to establish special training programs for them in mental hospitals or other mental health facilities. A carefully supervised apprenticeship, clerkship, or internship in such a setting might be arranged on a two-day per week basis for two months or on a half-day basis for six weeks, or on a more intensive basis for special agents *The content of training activities in the mental health field is also discussed below, under "Internship in a Clinical Setting." **See paper by Michels, page 107. 87

who will devote a good part of their Secret Service careers to assessing and managing potentially dangerous subjects. The goals of such a program would be to • expose special agents to a broad cross-section of mentally and emotionally disturbed persons • help them understand the differences between the (potentially) violent and non-violent mentally ill • permit them to observe mental health professionals making "imminent dangerousness" decisions • enable them to watch clinicians interview mentally and emotionally disturbed patients and thereby sharpen their own intuitive and interviewing skills • increase their repertoire of responses to and judgments about mentally and emotionally disturbed subjects • expose them to a full range of clinical management techniques and increase their understanding of the circumstances appropriate to each • help them feel more at ease in dealing with mental health professionals and institutions • enable them to handle their own stress more effectively when dealing with disturbed subjects.* Simulations, Gaming, and Senario Construction Frank Ochberg and others suggeste'd simulation, gaming, and scenario construction as devices useful for teaching special agents how to recognize and deal with less familiar but apparently increasing possibilities of harm to protected persons, such as hostage taking extortion, and terrorism. Such techniques are especially valuable in helping trainees anticipate and rehearse possible future events, thus contributing to their overall preparedness. R K. Gable and Hillel Einhorn, among others, noted that these techniques can also be used to sharpen agents' abilities to distinguish real from pseudo threats: true suicide notes from fabrications, threat messages written by real subjects from phony threat messages, the truly mentally ill from actors posing as disturbed subjects, and so forth. *Also see papers by Frazier and colleagues and by Michels, pages 93 and 107, respectively. 88

Special Training Program for Senior Agents Joseph English proposed a special training program for senior agents who are experienced and expert in assessing and managing potentially dangerous subjects. Such agents would be subsidized for post-graduate study in mental health, conducted by a teaching hospital in a hospital setting. Upon completion of this program, agents so trained would return to the Secret Service to instruct and supervise less experienced or beginning special agents in the mental health aspects of their preparation for assessing and managing potentially dangerous subjects. The principal advantage of such a program is that it would enable the Service to develop its own competency in the mental health field, which would lessen the need for Secret Service personnel to consult outsiders about subjects presenting mental and emotional problems. Elissa Benedek additionally noted that agents in training would also be more receptive and willing to ask questions if they received their instruction in this field from specially trained Secret Service agents rather than from mental health professionals. Training to Improve Agent Decision-Making Although little is known about how agents reach their dangerousness decisions,* conferees and Secret Service representatives alike acknowledged that there are some agents who, by virtue of extensive experience and/or innate talent, are notably adept at making decisions appropriate to the circumstances—whether they do so by an intuitive or rational process. Conferees suggested that the decision-making processes of these agents be carefully analyzed and used to model the decision-making behaviors of less experienced, less gifted, and novice agents. In the short run, this activity would probably increase the reliability with which decisions are made—the extent to which all agents use the same criteria in making their decisions. It would also enable supervisors and training personnel to pinpoint agents whose decision-making skills need improvement and/or who should be reassigned to other duties because of inadequate performance in this area. In the long run, improving the reliability of agent decisions would probably make it easier to test whether agent decisions are correct in terms of the actual level of risk posed by subjects. *A study of agent decision-making is currently in progress. 89

Retraining and Corrective Feedback In-service training for special agents is and should continue to be updated periodically, in order to sharpen skills and introduce new techniques and more sophisticated knowledge. Agents should be given feedback on their performance and taught to recognize their own errors and correct them. Untoward events, whether attempted or successful assassinations, killing or maiming of Secret Service agents, or close calls, should be reviewed with all special agents in an honest and non-defensive manner, so as to locate possible errors in judgment and inadequate protective measures. Such reviews constitute an important source of feedback on operations, as well as an appropriate mechanism by which government agencies and their employees assume responsibility for examining their own actions. 90

NOTE kinder Title 18 of the United States Code, section 3056 (18 USC 3056), the United States Secret Service is authorized to protect the following persons: the President of the United States and members of his immediate family; the President-elect and members of his immediate family, unless the members decline such protection; the Vice President or other officer next in order of succession to the Office of the President and members of his immediate family, unless the members decline such protection; the Vice President elect and members of his immediate family, unless the members decline such protection; a former President and his wife during his lifetime; the widow of a former President until her death or remarriage; the minor children of a former President until they reach age 16, unless such protection is declined; visiting heads of foreign states or foreign governments, and, at the direction of the President, other distinguished foreign visitors to the United States and official representatives of the United States performing special missions abroad; major Presidential and Vice Presidential candidates, unless such protection is declined; the spouse of a major Presidential or Vice Presidential nominee, commencing a maximum of 120 days prior to the general Presidential election. The number of persons protected by the Secret Service on any given day averages around 25 to 30, but may be as high as 70. The Secret Service also relies on Section 3056 as its basic legal authority to collect and disseminate intelligence information in connection with its protective duties. The Service is specifically authorized by section 3056 to detect and arrest any person who violates the so-called "threat statute" (18 USC 871) . This statute states in part: "(a) Whoever knowingly and willfully deposits for conveyance in the mail or for a delivery from.any post office or by any letter carrier any letter, paper, writing, print, missive, or document containing any threat to take the life of or to inflict bodily harm upon the President of the United States, the President-elect, the Vice President or other officer next in the order of succession to the office of the President of the United States, or the Vice President-elect, or knowingly or willfully otherwise makes any such threat against the President, President-elect, Vice President or other officer next in the order of succession to the office of President, or Vice President-elect, shall be fined not more than $1,000 or imprisoned not more than five years, or both." 91