1. Access To Justice – Pro se Litigants Awareness of Mental Health Resources
Gwen L. Zornberg, M.D., Sc.D.

2. Participation & Interaction
Animations step-by-step guide:
Click 1 – Highlights and opens VoIP audio settings menu
Click 2-3 – Highlights and activates Raise and Lower Hand feature
Click 4-6 – Highlights and steps through submitting questions and comments through the Q&A panel
Click 7 – Shows View Options menu at top of display

3. Gwen Zornberg, M.D., Sc.D. Assistant Attending Psychiatrist - NewYork-Presbyterian Hospital Assistant Professor of Psychiatry - Weill Cornell Medical College, Cornell University

4. Who works in the front lines directly with pro se litigants?

5. Who finds that at times there are challenges that may be time-consuming?

6. Agenda Pro Se Litigants and Access to Justice
Pro Se Litigants and Mental Health
Resources - Strategies
Q&A

7. Pro se litigants seek access to justice
In civil cases, pro se litigants brave the legal system without:
An attorney
Legal expertise
Knowledge of court systems
While clinics may be available to aid pro se litigants—setbacks arise from lack of knowledge.

8. (Legal Services Corporation, June 2017)
86% low-income Americans receive inadequate or no professional help for the civil legal problems they face.
(Legal Services Corporation, June 2017)

9. Attempts to navigate courts
Pro se litigants burdened by hardship
Lack of familiarity with court cultures
Lack of resources, impaired communication skills
Lack of legal knowledge

10. Stress reactions may be provoked facing -Negativity -Hostility
We must take human nature as we find it. Perfection falls not to the share of mortals.
- George Washington

11. Mental wellness pro se litigants
and
pro se litigants
Psychiatric conditions are common
Rich or poor.
All ethnic or racial groups.
Mental illness not competent
Human rights
Mental illness, in and of itself, is not a basis for depriving people of their rights.
Court Processes
Some pro se litigants face the demands of self-representation complicated by managing mental health conditions.

12. Mental health resources and access to the courts
What resources do we have to help distressed pro se litigants to cooperate with the court processes?

13. We do language. That may be the measure of our lives.
- Toni Morrison

14. STRATEGY R O L L E R S RAPPORT Observe Elicit Solutions LISTEN LISTEN
RESPECT
Solutions

15. RAPPORT

16. Observe

17. LISTEN

18. LISTEN

19. Elicit

20. RESPECT

21. Solve

22. There is no one-size-fits-all Strategy Adapt to each person in the situation
Rapport helps de-escalate and helps prevent escalation Observe Listen Elicit Respect Solve

23. Strategies Confrontation
Be Calm
breathe 3 times to build calm.

24. Inhale

25. Exhale

26. Inhale

27. Exhale

28. Inhale

29. Exhale

30. 1 2 3 Building Rapport Perspective
Sincere empathy with their predicament maintaining your professional demeanor. 3
☑ Speak softly, good eye contact, open body language.
Don’t say “I understand.” ☑ “Tell me more so I can better understand.”
☒ Avoid statements that begin with “You….”.
☒ Avoid finger pointing.

31. Confrontation – Deescalate. Aim to create rapport.
Communication builds momentum toward RAPPORT.
LISTEN
Take their frustration seriously—not personally.

32. ACTIVE LISTENING DEESCALATION
Sincere
ROLLERS
Rapport,
Listen
Repeat
back what they
said.
Calm
Breathe 3 times to build calm.
Thank Them
For bringing the
issue to your
attention

33. Paranoia – the range of severity is great
Appears paranoid
Have other people around
Security protocols
Maintain a formal, earnest, sincere, calm attitude.
Never say anything that can be used against you.
Choose every word carefully when speaking.
Trust your instincts, keep extra space between you & an agitated person.

34. Depressurize with your colleagues after a challenging interaction
Be Calm
Breathe 3 times to build calm.
Debrief
With others after
confrontation
Give
yourself
credit

35. Be alert for signs of intoxication or drug withdrawal
*If altered mental activity hinders ability to understand and respond to direction, they may be under the influence.
Clues: Opioids: small constricted pupils, respiratory depression Alcohol: slurred speech, disinhibited, unsteady Stimulants: wide dilated pupils, agitation / paranoia
Employ safety protocols as appropriate
Opioids - Narcan kits save lives.

36. Telephone strategy
If necessary, ask “Do you have business with the Court?”
If not, let them know you need to help the next person.
Politely end the call.

37. Self Physical Mental Communication Get enough sleep Rejuvenate
Exercise
Eat well
Mental
Rejuvenate
Enjoy what you love
Communication
Language is powerful
Words matter

38. Remember not only to say the right thing in the right place, but,
more difficult still, to leave unsaid the wrong thing at the tempting moment.
- Benjamin Franklin

39. Q&A

40. Keep Learning
Journal of the American Medical Association, Dec 25, 2018; 320; 24: p. 2586
MacKinnon RA, Michels R.  The Psychiatric Interview in clinical practice. WB Saunders, Philadelphia PA, Toronto Ontario, 1971.
Weill Cornell
Psychiatry
@WCMPsychiatry

41. THANK YOU!