1. Interacting with Persons Who May Have Who May Have Mental Health Issues

2. Our Goal Our Mission M G Improve knowledge base and skills of officers dealing with mentally ill people in crisis Build bridges between mental health and law enforcement Law Enforcement Liaisons

3. Is It a Police Emergency?  911 is your best friend!  Some of the information needed:  Who you are  Where you are  Nature of the call  Description of the party  What the party is doing/saying/telling you  Any weapons involved  Anyone injured  Call-back number

4. Is It a Police Emergency? (cont.)  Always try to remain calm when providing information  Be a good witness  Your safety and the safety of others is paramount!

5. The Fact and Fiction of Mental Illness They must be cared for; can’t make their own decisions They are less intelligent They are resistant to treatment and difficult to engage They are resistant to treatment and difficult to engage They are capable and have a right to make their own decisions No, it is the symptoms of mental illness No, the needs of the mentally ill are just more complex

6. The Fact and Fiction of Mental Illness Mental illness is a life- long disease with no cure Recovery possible; they can and do lead productive lives People with mental illness are more prone to violent acts Studies have shown only a weak association between mental illness and violence However there is an increased risk when alcohol or drug use is involved Studies have shown only a weak association between mental illness and violence However there is an increased risk when alcohol or drug use is involved

7. Please Remember… If an individual is having a mental health crisis:  The person may be overwhelmed by thoughts, beliefs, sounds (voices)  A person’s delusions or hallucinations are real to them  A rational discussion may not take place

8. Communication: Your Most Effective Tool  7% of communication is verbal  93% of communication is not communicated by spoken words When communicating always keep this in mind: Sometimes is is not about the words but how you say the words…  Your posture, your mannerisms  The words themselves

9. Time can be your friend. It may: Help reduce stress and anxiety Increase rationality Decrease emotions Person may “surrender” Allow you to gain more information to better enable responding law enforcement and EMS personnel to do their job If You Can Slow the Event Down…

10. Think about using verbal pacing techniques… Sensory: “I sense you are angry” Visual: “I see that you need help” Auditory: “I hear what you are saying” Regarding Your Interactions Attempt to get the individual talking so that you can fully understand why they are angry

11.  Announce actions before taking them  Be friendly, patient, accepting and encouraging but remain professional  Get immediate emergency aid when needed  Never promise anything you cannot do During Your Interactions

12. Steps for Successful Crisis Resolution 1 Active Listening 2 Empathy 3 Rapport 4 Influence 5 Behavioral Change Identification with, and an understanding of another’s situation, feelings and motives Building trust to solve the crisis A willingness on the part of the person to accept suggestions and a course of action A willingness on the part of the person to follow your suggestions Hearing and understanding what is being said to you

13.  Appear confident  Display calmness  Create some space  Speak slowly, gently and clearly  Lower your voice  Indicate a willingness to understand and help  Show that you are listening Diffusion Strategies

14.  Speak simply, move slowly  Do not challenge them  Show that you are paying attention  Calm the person and assure s/he feels heard before trying to solve the problem  Always attempt to gain voluntary compliance  Do not insult them Diffusion Strategies (cont.)

15. Interactions & Problem Solving  Ask the person to slow down  Don’t demand answers  Give the person enough personal space  Reassure person there is time to sort the situation out  Can you remove the source of agitation/anxiety?  Set limits on behavior  Be aware of threatening statements and take them seriously If you see this… What might help… Anxiety/ Agitation Aggressive/ Inappropriate Behavior

16. Interactions & Problem Solving If you see this… What might help…  Do not argue with hallucinations or delusions  Accept that this is what the person believes or perceives  Support reality based statements  Do not encourage statements that are not real  Be careful with use of touch  Allow person to formulate a response  Be patient Hallucinations Delusions Loss of Contact w/Reality Slow Response

17. Interactions & Problem Solving If you see this… What might help… Difficulty Establishing Directed Activity  Make expectations clear and concise  Help person identify meaningful tasks and break these down into doable tasks Difficulty Making Decisions  Limit number of decisions to be made  Take a directive stance that relate to a person’s safety Exaggerated Response  Use clear concise questions and statements

18. If you see this… What might help… Interactions & Problem Solving  Allow person to vent  Allow person to cry  Help in problem solving and making changes in behavior that will have an impact on feelings  Word sentences in simple terms  Ask one question at a time  Allow person time to form an answer/response Depression Frustration Loneliness Guilt Disorganized Illogical Thinking

19. Express anger/irritation or shout Mislead person Assume they cannot hear you Use inflammatory language Force discussions Move suddenly Challenge delusions/halluc inations Be very careful w/ your use of touch It is NOT personal Avoid Doing These Things

20. Protect yourself with distance, avoid being surrounded and maintain an open line of flight Never physically engage the person you are confronting Never argue with an intoxicated person - it may lead to a physical confrontation Never agree to meet the intoxicated person elsewhere or outside If your physical safety is threatened, call for assistance Rules for Personal Safety

21. If I think it is a person with mental health issues… …would the situation best be resolved with police assistance? For Emergencies call 911 Non-Emergencies use police business line