1. Barriers to De-escalation in Several Cultural Communities
Summary of suggestions from focus groups identifying barriers to effective mental health crisis response in the African American, American Indian, Hmong, Latino, and Somali communities in Minnesota.
How can officers overcome these barriers?

2. Community partners African American Women/Men in Need
American Indian Family Center
Comunidades Latinas Unidas En Servicio
Cultural Wellness Center
Hmong American Partnership
Nawayee Center School
One T Consulting
Somali Cultural and Human Services
Urban Strategies
White Bear Lake Police Department
St Paul Foundation
Bigalow Foundation

3. In a culture other than your own:
What is Culture
Culture is behavior that benefits the individual and the group in a particular environment
Humans create culture and are the products of culture
In a culture other than your own:
Listen, respect, learn
Tolerance within universal laws of human rights
To communicate, not necessarily to endorse

4. A Few Examples of Culture
bodily adornment
cooking
courtship
division of labor
dream interpretation
etiquette
folklore
community organization
government
greetings
hospitality
housing
language
law
penal sanctions
spirituality

5. My culture and other cultures
What is my culture?
What other cultures do I interact with on a regular basis?
When there is no crisis:
Learn the sources of their historical trauma
Learn about their culture
Get to know their elders and healers
Learn how their community views mental health and how they respond to mental illness?
Make connections to their community to increase credibility in the crisis moment

6. Ways of Interacting
Seeing culture as a resource for recovery from mental illness
Traditions: ways of responding to illness and recovery
Knowledge and insights
Practices: ways of providing support, care, and healing
Interacting with different cultures
Non-verbal: can be the same or different across cultures including respectful eye contact and comfortable distance
Language and English usage may be different
Family structure: respect leadership within the family
Ideas about mental illness and criminal justice vary
Ideas about the broader world, historical or personal experience with abusive authority figures all impact you
Any one race, nationality or population can contain many different cultures

7. Barriers Identified What is Trauma?
Physical (serious injury and threat)
Brain Injury
War/Terrorism/Political Violence
Victim/ Witness to Community Violence
Mental (frightening thoughts and painful feelings)
Racial experience and trauma (system induced trauma, internalized oppression, domestic violence, poverty)
Mental illness and trauma (incarceration, loss of family and friends)
Cultural trauma (forced displacement, natural disaster, unresolved grief)
Historical trauma (genocide, forced sterilization and adoptions)
Secondary trauma

8. Signs and Symptoms of Trauma
Intense fear or helplessness
Aggression
Hypervigilance
Flashbacks
Withdrawal or detachment
Lack of concentration
Irritability
Loss of emotional regulation
Lack of calm
Sleep disturbance
Hypersensitivity to emotion
High heart rate at rest, high blood pressure
Defense is disassociation

9. Barriers Identified (cont.)
 What is Stress?
From lack of safe housing or employment, community violence
Behavior may be from underlying untreated trauma or mental illness
Childhood trauma imposes un-named pain
Desire for response that is respectful of their culture and community
Want to cooperate with police but see possibility of good or bad coming from police response
Loss of rights, resources, culture, life and health
Stress makes responders forget their skills
Stress inhibits community member’s skills

10. Signs and Symptoms of Stress
Memory problems
Inability to concentrate
Poor judgment
Sees only the negative
Anxious or racing thoughts
Chest pain, rapid heartbeat
Irritability, short temper
Agitation, inability to relax
Sense of loneliness, isolation
Overwhelmed
Using alcohol, cigarettes, or drugs to relax

11. Barriers Identified (cont.)
Misunderstanding, lack of knowledge
You can’t resolve a problem until you first name it: MI, trauma, stress, abuse
Person feeling oppressed and not understanding you are there to help
Some community members don’t understand what mental health and mental health problems are
Lack of understanding of the justice system
Parents put up a front to protect kids, fear of child protection, family breakup
Lack of familiarity with clinical or legal terminology
The child is small in the big world and doesn’t understand what is happening or how to respond
Survival requires defense from the un-understood threat
Generalized response produces aggressive and depressed behaviors
Elders expect deference and humility from responders

12. Barriers Identified (cont.)
Lack of Trust
Stress of meeting a peace officer
Don’t know what to expect from first responder
Fear for the worst response, defensive posture
Officer trauma
Citizen as a threat, potential or real
Expectations affect the outcome in mental health response and in cultural response
Past abuse colors current interactions

13. Stress and Trauma impact officers and community members alike
“…any time the causal factor of a stressor is human in nature, the degree of trauma is usually more severe and longer lasing. In other words, when it is another human being who causes our fear, pain and suffering, it shatters, destroys and devastates us.
“It chews hungrily on so many of our law enforcement officers.
“It affects their job performance, their relationships and ultimately their health.”
Lt Col David Grossman, On Combat

14. Fuselier Behavioral Change Stairway
TRUST
INFLUENCE
RAPPORT
EMPATHY
ACTIVE LISTENING
SKILLS
TIME
G. Dwayne Fuselier, Ph.D., is a Clinical Psychologist and a retired FBI Supervisor who was part of the Columbine Investigative Team Task Force. Adapted from “Lessons from Columbine: What Parents can do to get their teenagers to talk with them.”De-escalation
Stairstep model

15. Active Listening
Separate person from problem (difficult behaviors, signs and symptoms of a disorder)
Open ended questions- “Tell me more about what happened here before I arrived. ”
Make a human connection.
Clarify your understanding of the person’s mental and physical state:
Have you been drinking?
Are you taking any drugs or medications?
Have you been diagnosed with a mental illness?
Do you have a family member or friend I can contact?
Do you have a doctor or clinic I can call? Know the resources that practices in their cultural group.

16. Empathy and Building Rapport
Be careful of what you say and how you say it so it is not misinterpreted. For example:
“ I understand how you feel.”
“Can I help you get what you need?”
“You can stop in any time you want.”
“Anything I can do to make you feel more comfortable?”
Set boundaries and give clear directions.
“You are too close. You have to stand there.”
“Pace in this area if you must pace.”
“You have to go the hospital because I am concerned about your health and safety.”

17. Questions? Mark Anderson Executive Director
Barbara Schneider Foundation
2419 Nicollet Av
Minneapolis, MN 55404