Law Enforcement Training in Texas

Document Sample
Law Enforcement Training in Texas Powered By Docstoc
					Crisis Intervention Training




         Intermediate CIT Course Number 3841
         Texas Commission on Law Enforcement
             Officer Standards and Education
                                               1
Unit Goal 1.1.

 To develop a basic understanding and
  respect for the fundamental rights of and
  proficiency in interacting with people with
  mental illness.




                                                2
Top Cop Video

(View „Top Cop‟ video from “Train the Trainer” course materials




                                                                  3
1.1.1.

 Discuss the impetus for crisis intervention
  training and why it is so important to the law
  enforcement community.




                                                   4
Origin of the Training

 Memphis (TN) officers shot and killed a 26-
  year-old male who was cutting himself with a
  knife and threatening suicide

 The public outcry in the aftermath of the
  shooting caused the mayor to establish a task
  force



                                                 5
Origin of the Training


 Crisis Intervention Training (CIT) was created




                           -Practitioner Perspective
                           -Bureau of Justice Assistance
                           July 2000


                                                           6
Similar Situations Today

 “The San Francisco Police Commission
 approved a $500,000 legal settlement with
 the family of a mentally disturbed man who
 was shot and killed in 2001 by police as he
 waved a knife at them in a theater.”


                          — Jaxon Van Derbeken
                          — San Francisco Chronicle
                            June 5, 2003

                                                      7
Similar Situations Today

 “The fatal shooting of a mentally ill man on
  Thursday marked the third time in six months
  that Philadelphia police have used deadly
  force to subdue an unruly person in need of
  psychiatric help.”


                 “Police Shootings of Mentally Ill Show Training Needed”
                  www.HealthyPlace.com
                 February 21, 2004


                                                                      8
Similar Situations Today

 “The Miami-Dade police department in
  southern Florida began sending every officer
  to a two-day class entitled „Managing
  Encounters with the Mentally Ill‟ … after
  officers killed a 19-year-old man suffering
  from bipolar disorder.”

                 “Police Shootings of Mentally Ill Show Training Needed”
                 —www.HealthyPlace.com
                 — February 21, 2004

                                                                    9
Similar Situations Today

 “A 16-year Austin police officer used deadly
  force Tuesday morning, killing an east Austin
  woman as she apparently tried to attack a
  housing manager with a butcher knife. …
  within moments of the shooting, east Austin
  residents were questioning whether the
  woman‟s death could have been avoided.”
                            —www.news8austin.com
                            — Incident occurred in 2002

                                                          10
Similar Situations Today

 The treatment advocacy center in
  Washington, D.C. reported that people with
  psychiatric disabilities are four times as likely
  to die in encounters with police as members
  of the general population.


                               — Treatment Advocacy Center
                                 Washington DC


                                                             11
Headlines…


   “Crisis Skills Advised for Local Police”

   “Report: Grand jury finds that most fatal
   shootings by law enforcement officers in
  last decade involved a mentally ill person”


                             — Los Angeles Times
                             — Ventura County Edition
                             — February 27, 2002
                                                        12
Headlines…

     “Training urged after police shooting”

“The weekend death of a mentally disabled man
      shot by a Miami-Dade police officer…
  department to offer its officers more intensive
                    training.”



                         — The Miami Herald
                         — Herald.com
                         — Posted Thursday, October 28, 2004
                                                               13
1.1.2.

 Recognize the community mindset as it
  relates to the mentally ill‟s relationship with
  law enforcement personnel




                                                    14
Community Mindset

 Individuals with mental illness are traditionally
  not hardened criminals and should not be
  treated as such. Law enforcement should
  respond differently to individuals in mental
  health crises. Force, in these situations, is
  highly scrutinized.




                                                  15
The Problem

 Re-occurring situations in which law
  enforcement uses deadly force during
  encounters with individuals in serious mental
  health crisis




                                                  16
Aspects of the Problem

 “There is no question that law enforcement
  officers are increasingly the ones responding
  to people with mental illnesses who are in
  crisis.”



                      — Treatment Advocacy Center Briefing Paper
                      — www.psychlaws.org
                      — 10/2004

                                                             17
Results
 Lawsuits/Liability

 Lack of trust/confidence in law enforcement
  by mental health consumers and their
  families
 Frustration of law enforcement due to
  uncertainty of how to handle these calls




                                                18
Analysis of the Problem

 Lack of education/understanding of mental
  illness by law enforcement
 The same physical, authoritative, command
  tactics employed to take a criminal suspect
  into custody are used in responses to
  individuals in mental health crises



                                                19
Analysis…

 Individuals with mental illness are traditionally
  not hardened criminals.
 The public views these individuals as ill, not
  criminal. The public expects law enforcement
  personnel to help not hurt.




                                                   20
Analysis…

 An analysis of 1439 CIT calls revealed that only 1%
  of the individuals in a mental health crisis were
  arrested.

 Of the remaining 99% of the incidents, no crime or a
  petty class C crime was committed without arrest.




                                    Houston Police Department 2004


                                                              21
Analysis…

 Response to individuals in a mental health
  crisis constitutes a more refined usage of the
  officer‟s expertise in communication.

 “If police perform their role effectively, our
  society benefits immeasurably; if the police
  perform their role poorly, the damage to
  public confidence and democratic principles
  can be irreparable.” (Louis/Resendez, 1997)

                                                   22
The Responses: 3 Models

 Police-based specialized police response
  (CIT)
 Police-based specialized mental health
  response
 Mental-health-based specialized mental
  health response


                                             23
1.1.3

 Illustrate the paradox of Crisis Intervention
  Training for the law enforcement officer.




                                                  24
The Paradox

 By taking a less physical, less authoritative,
  less controlling, less confrontational approach
  the officer usually has more authority and
  control over the person in a mental health
  crisis.




                                                   25
Police Magazine (March 2000)

 “The essential difference between suspect
  encounter training, that officers traditionally
  receive, and how to approach the mentally ill
  is the need to be non-confrontational. Such a
  requirement to, in effect, switch gears is
  diametrically opposed to the way officers are
  routinely expected to control conflict.”


                                                    26
Police Magazine (March 2000)

 “The same command techniques that are
 employed to take a criminal suspect into
 custody can only service to escalate a contact
 with the mentally ill into violence.”




                                              27
1.1.4.

 Explain Crisis Intervention‟s role in Officer
  Safety




                                                  28
CIT Model

 “CIT has been shown to positively impact
  officer perceptions, decrease the need for
  higher levels of police intervention, decrease
  officer injuries, and re-direct those in crisis
  from the criminal justice to the health care
  system.”


                   Randolph Dupont, PhD. and Sam Cochran, MS
                   J Am Acad Psychiatry Law 28:338-44, 2000
                                                               29
This Training…

 Is officer safety training that is proven to help
  keep YOU and the mentally ill consumer safe.
 Is NOT in conflict with any tactical training
  you have received
 Instills confidence in officers regarding their
  ability to handle crisis situations




                                                      30
This Training…

 Is proven to be effective in helping you
  verbally de-escalate these situations
 Reduces lawsuits

 Is designed for calls involving individuals with
  mental illness but is applicable in many other
  areas of law enforcement



                                                   31
This Training…

 Is one more tool to add to your tool belt, one
  more skill to add to your repertoire of skills.




                                                    32
Officer Safety


 The Phoenix, Arizona Police Department
  reported that CIT training increased their
  officer safety by 70%



                           — Phoenix Police Department 2004



                                                          33
Safety…

 FBI statistics state that mentally ill consumers
  are no more prone to violence than any other
  area of the population.

 HOWEVER, the variables (mental instability,
  high emotions, possible paranoia/delusions
  and substance abuse) can be very dangerous
  if not handled appropriately.

                                                 34
Safety…

 When a person feels cornered, especially if
  psychotic, chances are high their response
  would be violent.

 In crisis, reason takes a back seat to emotion.




                                                35
Law Enforcement Policy Center

 “It is helpful for officers to understand the
  symptomatic behavior of persons who are
  afflicted with a form of mental illness. In this
  way, officers are in a better position to
  formulate appropriate strategies for gaining
  the individual‟s compliance.”




                                                     36
Law Enforcement Policy Center


 “Officers should first take time, if possible, to
  survey the situation in order to gather
  necessary information and avoid hasty and
  potentially counterproductive decisions and
  actions.”




                                                      37
Law Enforcement Policy Center

 “Officers should avoid approaching the
  subject until a degree of rapport has been
  developed.”

 “All attempts should be used to communicate
  with the person first by allowing him to
  ventilate.”


                                                38
Police Ex. Research Forum

 “Do not rush the person or crowd his personal
  space. Any attempt to force an issue may
  quickly backfire in the form of violence.”
 “He may be waving his fists, or a knife, or
  yelling. If the situation is secure, and if no one
  can be accidentally harmed by the individual,
  you should adopt a non-confrontational
  stance with the subject.”


                                                   39
FBI Law Enforcement Bulletin

• What is considered an area of specialized
  training may soon become standard training
  curriculum
• Law enforcement agencies must identify
  methods to safeguard their officers while, at
  the same time, protecting Consumers from
  themselves and others

                                      — July 2004 Issue


                                                      40
CIT Programs Nationally
 Akron (OH) Delray Beach (FL)    Knoxville (TN) Minneapolis
                                    (MN)
 Ft. Wayne (IN)
                                  Montgomery County (MD)
 Houston (TX)
                                  New London (CT)
 Jackson County (MO)
                                  San Jose (CA)
 Kansas City (MO)
                                  Seattle (WA)
 Albuquerque (NM)
                                  Lee‟s Summit (MO)
 Arlington (TX)
                                  Lincoln (NE)
 Athens-Clarke County (GA)
                                  Little Rock (AR)
 Austin (TX)
                                  Memphis (TN)

                                                                41
Additionally, this training…

 Instills confidence in the community regarding
  officers‟ ability to handle crisis situations
 Brings law enforcement and mental health
  together




                                                  42
However, this training

 Is not infallible…
          but is proven to be highly effective




                                                 43
Force

 Force may be needed, even deadly force
 It should be used as a last resort
 It will be highly scrutinized
 If force is used, most people will respond in
  kind, especially in these situations




                                                  44
Force

 Remember, in many instances the person
  has committed no crime
 You will fare much better if you can
  demonstrate you attempted to use other
  tactics before using deadly force




                                           45
1.1.5.

 Identify the parameters of an officer‟s
  qualification after receiving this training.




                                                 46
This training…

 Does not make you a therapist. Understand
  your professional boundaries.




                                              47
No CIT

(View „Psychosis I‟ video from “Train the Trainer” resource material)




                                                                        48
After CIT
 (View „Psychosis 2‟ video from “Train the Trainer” resource material)




                                                                         49
Unit Goal: 2.1.

 To sensitize the student to the adversity of
  mental illness.




                                                 50
1.2.1.

 Define the term “mental illness”.




                                      51
Definitions:

 General Definition of Mental Illness.
 Professional Definition of Mental Illness.
 Definition of Insanity.
 Abnormal vs. Normal Behavior.




                                               52
Basic Facts

 There are two distinct types of mental
  illnesses
     Serious to persistent mental illnesses
      which are caused by psychological,
      biological, genetic, or environmental
      conditions
     Situational mental illnesses due to severe
      stress which may be only temporary

                                                   53
Basic Facts

 Anyone can have a mental illness, regardless
  of age, gender, race or socio-economic level.
 Mental illnesses are more common than
  cancer, diabetes, heart disease or AIDS.
 Mental illness can occur at any age.



                                              54
Basic Facts


 20 - 25% of individuals may be affected by
  mental illness.

 7.5 million children are affected by mental,
  developmental or behavioral disorders.




                                                 55
Basic Facts


 Nearly two-thirds of all people with a
  diagnosable mental disorder do not seek
  treatment.




                                            56
Basic Facts


 With proper treatment, many people affected
  with mental illness can return to normal,
  productive lives.

 Mental illness can - and should - be treated.



                       — Basic Facts About Mental Illness
                       — NAMI Texas
                                                            57
 OCD Video

(View video newscast from “Train the Trainer” materials-updated version ))




                                                                             58
1.2.2.

 List four prominent categories of mental
  illness.




                                             59
Categories of mental illness

 Personality Disorders
 Mood Disorders
 Psychosis
 Developmental Disorders




                               60
1.2.3. Personality Disorders

 Discuss Personality Disorders as they relate
  to officer contact.




                                                 61
Personality Disorders

 Many individuals who are functioning well in
  their lives may still have a personality
  disorder.
 Many with personality disorders also suffer
  with depression.
 May be seen in persons with chemical
  dependency problems.


                                                 62
Causes

 It is believed that most personality disorders
  are caused by, family history of physical or
  emotional abuse, lack of structure and
  responsibility, poor relationship with
  parent(s), and alcohol or drug abuse.




                                                   63
1.2.4.

 List the three most common personality
  disorders encountered by law enforcement
  officers.




                                             64
Personality Disorders

 Paranoid


 Antisocial


 Borderline




                        65
Paranoid

 Interpret actions of others as threatening.


 Foresee being harmed.


 Perceive dismissiveness by others.




                                                66
Antisocial

 Most commonly in males.

 Irresponsible antisocial behavior.

 Diagnosed after age 18.

 Trouble with authority.

 Know doing wrong, do it anyway.
                                       67
Antisocial-possible traits

 History of truancy or runaway
 Starting fights
 Using weapons
 Physically abusing animals or people
 Lying
 Stealing or other illegal behavior



                                         68
 Borderline

 Most commonly recognized in females


 Possible traits:
-Unstable and intense personal relationships
-Impulsiveness with relationships, spending, food,
   drugs, sex
-Intense anger or loss of control

                                                 69
Borderline

 Continued…
- Recurrent suicidal threats
- Chronic feelings of emptiness or boredom
- Feelings of abandonment




                                             70
1.2.5.

 Identify prevalent behaviors associated with
  personality disorders.




                                                 71
Behaviors

 Usually do not seek treatment because they
  do not think there is a problem.

 „Normal‟ functioning, but display specific
  personality traits (inflexible, maladaptive,
  situational inappropriateness).

 Believe problems are caused by outside
  sources or „system‟ at large.
                                                 72
Behaviors…continued

 Behavior may lead to breaking laws (theft,
  hot-check writing, fraud etc.) and activity in
  the criminal justice system.
 Alcohol and illegal drugs are commonly used
  to „self medicate‟ as a result of stress and
  behavioral consequences.
 Often need treatment for chemical
  dependency or depression.

                                                   73
1.2.6. Mood Disorders

 Discuss Mood Disorders as they relate to
  officer contact.




                                             74
Mood Disorders

 Mental Illness demonstrated by disturbances
  in emotional reactions and feelings.

 Recognizable behaviors could include:

- Lack of interest and pleasure in activities

- Extreme and rapid mood swings

                                                75
Recognizable Behaviors
continued…

- Impaired judgment


- Explosive temper


- Increased spending


- Delusions

                         76
Causes of Mood Disorders

 Researchers believe (SAMHSA) that a
  complex imbalance in the brain‟s chemical
  activity plays a prominent role in selectivity.

 Environmental factors can trigger or buffer
  against the onset.



                                                    77
1.2.7.

 List the two most common mood disorders
  encountered by law enforcement officers.




                                             78
Mood Disorders

 Depression


 Bipolar Disorder




                     79
Depression


 Depression is a natural reaction to trauma,
  loss, death or change.

 A major depressive syndrome is defined as a
  depressed mood or loss of interest at least
  two weeks in duration.



                                                80
Major Depression


 Unlike normal emotional experiences of
  sadness, loss, or passing mood states, major
  depression is persistent and can significantly
  interfere with an individual‟s thoughts,
  behavior, mood, activity, and physical health.




                                               81
Symptoms of Major Depression

 Profoundly sad or irritable mood

 Pronounced changes in sleep, appetite, and
  energy

 Difficulty thinking, concentrating, and
  remembering


                                               82
Symptoms continued…


 Physical slowing or agitation

 Loss of interest in usual activities

 Feelings of hopelessness or excessive guilt

 Recurrent thoughts of death or suicide



                                                83
Symptoms continued…

 Persistent physical symptoms that do not
  respond to treatment, such as headaches,
  digestive disorders, and chronic pain.




                                             84
Causes


 There is no one single cause of major
  depression. Psychological, biological,
  genetic, and environmental factors may all
  contribute to its development.




                                               85
Major Depression


 Affects approximately 9.9 million American
  adults, or about 5.0 percent of the U.S.
  population age 18 and older in a given year.




                                                 86
Major Depression


 Nearly twice as many women as men suffer
  from major depression

 While major depressive disorder can develop
  at any age, the average age at onset is the
  mid-twenties.



                                                87
Manic Depression Video

(View „Manic Depression‟ video from “Train the Trainer” (updated version)
    course materials)




                                                                            88
Bipolar Disorder

 Mental Illness involving mania (an intense
  enthusiasm) and depression (as discussed
  previously).
 Bipolar disorder causes extreme shifts in
  mood, energy, and functioning.
 Chronic disease affecting more than two
  million individuals in the U.S.

                                               89
Symptoms of Mania


 Elated, happy mood or irritable, angry,
  unpleasant mood

 Increased activity or energy

 Inflated self-esteem

 Decreased need for sleep


                                            90
Symptoms…continued


 Streaming ideas or feeling of thoughts racing

 More talkative than usual

 Excessive risk-taking

 Ambitious often grandiose plans

 Increased sexual interest and activity

                                                  91
Symptoms of Depression


 Prolonged feelings of sadness or
  hopelessness

 Fatigue/low energy

 Difficulty concentrating or deciding

 Lack of interest


                                         92
Causes

 While the exact cause of bipolar disorder is
  not known, researchers believe it is the result
  of a chemical imbalance of the brain.
  Scientists have found evidence of a genetic
  predisposition to the illness.




                                                 93
Causes continued…

 Sometimes serious life events such as a
  serious loss, chronic illness, or financial
  problem, may trigger an episode in
  individuals with a predisposition to the
  disorder.




                                                94
Bipolar Disorder


 Affects approximately 2.3 million American
  adults, or about 1.2 percent of the U.S.
  population age 18 and older in a given year.




                                                 95
Bipolar Disorder


 The average age at onset for a first manic
  episode is the early twenties.

 Men and women are equally likely to develop
  bipolar disorder.




                                                96
1.2.8.       Psychosis

 Discuss Psychosis and how it relates to
  officer contact.




                                            97
Definition

 “A group of serious and often debilitating
  mental disorders that may be of organic or
  psychological origin and are characterized by
  some or all of the following symptoms:

- impaired thinking and reasoning ability
- Perceptual distortions
- Inappropriate emotional responses
                                               98
Definition continued…

- Inappropriate affect

- Regressive behavior

- Reduced impulse control and

- Impaired reasoning of reality.”


                            Social Work Dictionary, 2nd Edition,
                            by Robert L. Baker
                                                               99
Continued…

 A distortion of reality that may be
  accompanied by delusions and
  hallucinations.

 Delusion: False beliefs not based on factual
  information.

 Hallucination: Distortion in the senses….experiencing
  auditory or visual feedback that is not there.
                                                     100
1.2.9.

 Briefly illustrate a psychotic episode from a
  consumer‟s perspective.




                                                  101
Psychosis Video

(View „‟20/20 newscast‟ from “Train the Trainer” materials)




                                                              102
Common experiences

 Hearing voices: „Die, die, die‟, „Kill yourself‟,
  „You‟re no good‟, „They are going to get you‟.

 Feelings of Paranoia

 Visual hallucinations

 Heightening of senses

                                                      103
1.2.10.

 Inventory the behavioral/emotional cues a
  person displays when experiencing a
  psychotic episode.




                                              104
Cues

 Behavioral Cues: Inappropriate dress,
  impulsive body movements, causing injury to
  self.

 Emotional Cues: Lack of emotional response,
  inappropriate emotional reactions.



                                            105
Class Exercise




       (Refer to Instructor Resource Guide)

                                              106
1.2.11. Substance Abuse
        Cognitive Disorders

 Explain how substance abuse and cognitive
  disorders relate to psychosis.




                                              107
108
Substance Abuse/Cognitive Disorders‟
Relationship to Psychosis

 Prolonged use of drugs may cause symptoms
  of psychosis. (To include alcohol, prescriptions or „street drugs‟)
 Due to damage to the central nervous system

 Could create defects in perception, language,
  memory, and cognition.

 Addiction possible and Treatment may be
  needed

                                                                        109
Drug Specific

 Smoking a stimulant like crack cocaine can
  cause paranoid symptoms.

 Acute intoxication as well as withdrawal from
  alcohol can produce hallucinations.

 Prolonged use of alcohol can also produce
  depressive symptoms.
                                               110
Cautions
(for mental illness and substance usage)

 Illegal drugs and alcohol usage can have an
  adverse effect when used in combination with
  prescribed medications.

 „Masking Effect‟ of more severe symptoms.


 Risk of dependency and „roller coaster‟ effect.


                                                111
Referrals

 Substance Abuse treatment is a critical
  element in a comprehensive system of care.

 The most successful models of treatment for
  persons with co-occurring disorders contain
  integrated mental health and substance
  abuse services.


                                                112
Tartive Dyskensia

 A neuromuscular disorder caused by long-
  term use of neuroleptic drugs, which are
  prescribed for psychiatric disorders

 Not considered a mental illness within
  itself…drugs utilized to treat can lead to TD

 The neurotransmitters are blocked which over
  time may cause uncontrolled involuntary
  movement of the body and face
                                                  113
Continued…

 Treatment is highly individualized and should
  be monitored by the physician for a plan of
  action

 Excessive, quick movement is common.

  Note: This movement may distract or trigger defensive actions
  from the officer when not needed, which could escalate a
  situation unknowingly.

                                                                  114
1.2.12. Schizophrenia

 Discuss Schizophrenia as it relates to
  psychosis.




                                           115
Schizophrenia

 Group of psychotic disorders characterized
  by changes in perception.

 Affects a person‟s ability to think clearly,
  manage his or her emotions, make decisions,
  relate to others, and distinguish fact from
  fiction.



                                                 116
Distorted thinking…

 Results in:
- Hallucinations
- Poor processing of information/Attention
  deficit
- Illogical thinking that can result in
  disorganized and rambling speech and
  delusions.


                                             117
Changes in Emotion…

 May overreact to situation.


 Have “flat effect” (Decreased emotional
  expressiveness, diminished facial expression
  and apathetic appearance).




                                             118
Changes in Emotion…continued

 Anhedonia: Lacking pleasure or interest in
  activities that were once enjoyable.

 Withdrawn: Media tends to portray as violent
  which is very rare.




                                                 119
Causes of Schizophrenia


 Like many other medical illnesses,
  schizophrenia appears to be caused by
  genetic vulnerability and environmental
  factors that occur during a person‟s prenatal
  development.




                                                  120
Schizophrenia

 It affects approximately 2.2 million individuals
  in the U.S. age 18 and older in a given year.

 Ranks among the top 10 causes of disability
  in developed countries worldwide.

 Higher risk of suicide. Approximately 10% of
  people with schizophrenia commit suicide.
                                                  121
1.2.13. Alzheimer’s

 Discuss Alzheimer‟s disease and its
  involvement with psychosis.




                                        122
Alzheimer‟s Disease

 The most common organic disorder of older
  people.
 Affects an estimated 2-3 million Americans
  with over 11,000 dying per year.
 Duration of illness; from onset of symptoms to
  death, averages 8 to 10 years



                                               123
Symptoms of Alzheimer‟s

 Symptoms of disease are progressive
 The individual may get lost easily.
 Memory decreases over time.
 Becomes easily agitated.
 Symptoms can be psychotic-like in nature.




                                              124
Alzheimer‟s - Additional Facts

 Alzheimer‟s is a form of dementia.
 NOT considered a mental illness and most
  mental health facilities do not accept as
  patients.
 Drugs can help the progression of the
  disease but there is no cure.



                                              125
1.2.14. Psychotic Episode

 Demonstrate the communicative approach an
 officer should take when confronting a person
 in a psychotic episode.




                                             126
Communicative Approach

 Be cautious
 Never startle the person
 Be patient, you may have to repeat several
  times
 Try to learn the persons name and use it
 Talk in a calm, soft tone of voice



                                               127
Continued…

 Allow person to verbally ventilate
 Be aware of individuals „personal space‟
 Introduce self
 Assure person of officers intentions to help,
  not hurt




                                                  128
1.2.15.

 Appraise personal impressions of mental
  illness after viewing the consumer
  presentation.




                                            129
Consumer Presentation
(View „Jack Callahan‟ video from “Train the Trainer” course materials)




                                                                         130
1.2.16. Developmental Disorders

 List the two most common developmental
 disorders that relate to officer contact.




                                             131
Developmental Disorders

Two most common:

 Autism
 Mental Retardation




                          132
Autism:

 Affects 1 to 2 in 1,000 Americans.
 Appears before age 3.
 Characteristics: abnormal speech patterns,
  lack of eye contact, obsessive body
  movements, social isolation, ritualistic or
  habitual behavior, attachment to objects,
  resistance to change and sensory disorders.


                                                133
Autism…Communication Behaviors

 May be verbally limited
 Abnormal pitch, rate or volume when
  speaking
 Difficulty expressing needs, ideas or abstract
  concepts
 Reversal of pronouns or other parts of
  speech


                                               134
Autism…Other Behaviors

 Matching, pairing and ordering objects
 Blinking compulsively
 Switching lights on and off
 Jumping, rocking, clapping, chin-tapping,
  head-banging, spinning
 Fascination with colorful and shiny objects



                                                135
Autism Video

(View „Autism‟ video from “Train the Trainer” (updated version) course
    materials))




                                                                         136
Mental Retardation

 Refers to a range of substantial limitations in
  mental functioning manifested in persons
  before the age of 18.




                                                    137
Most common Characteristics

 Significantly sub-average intellectual
  functioning
 Limitations in two or more adaptive skill
  areas, such as; communication, self-care,
  home living, safety, academic functioning and
  work
 Deficits in adaptive behavior


                                              138
Degrees of Mental Retardation


 Moderate: IQ 54-40


 Severe: IQ 39-25


 Profound: IQ Below 25



                                139
Methods for Questioning

 Be patient for a reply
 Repeat question as needed
 Ask short, simple questions using simple
  language
 Speak slowly




                                             140
Methods…continued

 Move to a less disruptive location to assist
  with focusing

 Be non-threatening, but firm and persistent


 Be highly aware of questioning techniques



                                                 141
Areas to Consider to Assist in
Identification

 Criminal Activity
 Educational History
 Physical Appearance
 Speech/Language
 Social Behavior
 Performance Tasks



                                 142
Strategies for Identification:
Criminal Activity

 Noticeably older than others involved in
  offense

 Follower

 Ready to Confess

 Remained at scene while others ran

                                             143
Strategies for Identification:
Educational History

 Below usual grade level


 ID states mental impairments


 Check MHMR records




                                 144
Strategies for Identification:
Physical Appearance

 Inappropriately dressed for season


 Unusual physical structure


 Awkwardness of movement/poor motor skills


 Difficulty writing

                                          145
Strategies for Identification:
Speech/Language

 Obvious speech defects


 Limited response or understanding


 Inattentiveness


 Difficulty describing facts in detail

                                          146
Strategies for Identification:
Social Behavior

 Adult associating with children or adolescents


 Eager to please


 Non-age appropriate behavior


 Easily influenced by others

                                               147
Strategies of Identification:
Performance Tasks to Utilize
 Read/Write simple phrases

 Give directions to their home

 Tell time

 Count to 100 by multiples of five

 Explain how to make change for a dollar
                                            148
Mental Illness (MI) vs.
Mental Retardation (MR)
 American Population Statistics: 3% MR, 22.1% MI.


 MI unrelated to intelligence, while MR is below-level
  intellectual functioning.

 MI develops at any point in life, MR prior to age 18.


 No cure for either however, medications can help MI.



            Reference: Special Olympics (http://www.specialolympics .org)
                                                                            149
1.2.17. Developmental Disorders

 Discuss Developmental Disorders as they
  relate to officer contact.




                                            150
Definition

 A developmental disability is a severe,
  chronic disability of a person five years of age
  or older.

 Such a disability:
- Is attributable to a mental or physical
   impairment or combination of the two.


                                                151
Definition Continued…

 Is manifested prior to the age of 22.


 Is likely to continue indefinitely.


 Displayed through substantial limitation of
  three or more life activities.



                                                152
Needs

 For lifelong or extended care, treatment or
  other services which are planned according
  to persons needs.

 Infants and children with developmental
  disabilities, have substantially delayed
  development, or congenial or acquired
  conditions and are likely to have limited life
  involvement if services are not provided to
  them.
                                                   153
1.2.18.

 Identify behaviors associated with
  Developmental Disorders as they relate to
  officer contact.




                                              154
Behaviors

 May be overwhelmed by police presence

 May attempt to run out of fear of uniform

 May confess to a crime to please officer and
  end uncomfortable questioning

 Is a concrete thinker

                                                 155
Behaviors…continued

 Needs visual cues to assist in understanding


 May need a more in-depth explanation of
  their rights

 May be sensitive to touch, creating „fight or
  flight‟ reaction

                                                  156
Unit Goal 1.3.

 To develop a knowledge base concerning
 suicide and the evaluation of danger levels.




                                                157
1.3.1 Suicide

 Verbalize commonly stated myths about
  suicide:




                                          158
Myths…

 People who talk about suicide won‟t commit
  suicide.
 People who commit suicide are “crazy.”
 Once the person begins to improve, the risk
  has ended.
 Prior unsuccessful suicide attempts means
  there will never be a successful suicide.


                                                159
Fact

 “There is no typical suicide victim. It happens
  to young and old, rich and poor.”




                               American Association of Suicidology




                                                               160
1.3.2.

 Discuss suicide and its relationship with
  mental illness.




                                              161
Suicide and Mental Illness

 90% of suicides are reportedly related to
  untreated or under-treated mental illness

 The most common mental illness associated
  with suicide is depression




                                              162
Continued…

 Nearly 20% of people diagnosed with bipolar
  disorder die from suicide

 Nearly 15% of people diagnosed with
  Schizophrenia die from suicide




                                            163
1.3.3.

 Explain the phrase “suicide by cop”.




                                         164
“Suicide by Cop”

 “People with severe mental illness are killed
  by police in justifiable homicides at a rate
  nearly four times greater than the general
  public”




                                                  165
Continued…

 “One study…found that incidents determined
  to be suicide by cop accounted for 11% of all
  police shootings and 13% of all fatal
  shootings. The study found that suspects
  involved in such cases intended to commit
  suicide, specifically wanted to be shot by the
  police…provoking law enforcement officers
  into shooting them.”

                             Treatment Advocacy Center
                                                         166
1.3.4.

 Record questions that will assist in evaluating
  an individual„s current level of suicidal
  danger.




                                                167
Evaluating Level of
Suicidal Danger
 Symptoms?


 Nature of current stressor?


 Method and degree?


 Prior attempt?

                                168
Levels of danger…continued

 Acute vs. chronic?


 Medical status?


 Chance of rescue?


 Social resources?

                             169
Danger to Self

 Intent (actions/words)


 Gross neglect for personal safety


 Specific plan (action/words)


 Plans/means available

                                      170
Danger to Others

 Intent (actions/words)


 Specific person identified


 Agitated, angry, explosive


 Irrational, impulsive, reckless (intent/actual)

                                                    171
Statistics

Males        Method          Females
66%          Firearms        39%
13%          Poison          40%
15%          Strangulation   10%
1%           Cutting         1%
5%           Other           10%


                                       172
Statistics

  Rank       State        Rate
  1          Nevada       22.3
  5          Alaska       15.5
  14         Florida      13.4
  39         Texas        10.0
  50         New York     6.6
  51         Wash. D.C.   5.8



                                 173
  Suicide Video #1

(View #1 „Depression, Suicide‟ video from “Train the Trainer” course materials)




                                                                            174
  Suicide Video #2

(View #2 „Depression, suicide‟ video from “Train the Trainer „course materials)




                                                                            175
Unit Goal: 1.4.

 Discuss Psychopharmacology as it relates to
  medications prescribed and prominent side
  effects in persons with a mental illness.




                                              176
1.4.1.

 Name four categories of medications utilized
  in controlling the symptoms of mental illness.




                                                 177
Categories of drugs

 Anti-psychotic


     Thorazine, Mellaril, Haldol
     Controls hallucinations
     Ex: Schizophrenia




                                    178
Categories…continued

 Antidepressants


     Elavil, Prozac, Zoloft
     Control feelings of sadness, hopelessness,
      suicidal thoughts
     Ex: depression



                                                   179
Categories…continued

 Mood Stabilizers


     Tegratol, Lithium, Depakote
     Control mood swings
     Ex: bipolar disorder




                                    180
Categories…continued

 Anti-anxiety drugs


     Xanax, Valium, Buspar
     Feeling of powerlessness, extreme
      apprehension, panic
     Ex: Phobia‟s, Post Traumatic Stress Disorder



                                                     181
1.4.2.

 List possible side effects with the use of
  psychotropic medications.




                                               182
Examples of side effects

 Muscle spasms            Nausea
 Protruding tongue        Headache
 Eyes rolled back         Blurred vision
 Constant leg movement    Weight gain
 Tremors                  Fatigue
 Uncoordinated            Liver toxicity
  movements
 Impotence


                                             183
Side effects can be…

 Uncomfortable


 Dehumanizing


 Often irreversible




                       184
Side effects….continued

 Some side effects are permanent, even after
  medications are stopped

 Some of these medications are associated
  with neurological damage

 Some of these medications can be lethal


                                                185
1.4.3.

 Discuss “old” vs. “new” medications.




                                         186
„Old‟ vs. „New‟ Medications

 „New‟ Drugs have significantly fewer side
  effects

 „Old ‟ Drugs still used today especially with
  indigent, jail populations etc. due to lower
  cost



                                                  187
1.4.4.

 Recognize three primary reasons why
  consumers do not take their medications as
  prescribed.




                                               188
Why medications are not taken

 Side effects
 Sigma
 Start feeling better


 Continuous problem for law
  enforcement…the above deviations are the
  primary cause of crisis concerns.

                                             189
Note: Right to Refuse Treatment

 May not administer a psychotropic medication
  to a person that refuses to take voluntarily
  unless related to an emergency or court order

 Would you want to take these medications?


 Is the treatment worse than the illness?


                                              190
Unit Goal: 1.5.

 To orient students to a variety of advanced
  modes of communication.




                                                191
1.5.1.

 List the components of the “first three minute
  assessment”.




                                               192
First Three Minute Assessment:
Four Components

 Elements of Evaluation


 Intellectual Functioning


 Behavioral Reactions


 Emotional Reactions

                                 193
Elements of Evaluation

 Appearance and     Affect-prevailing
  Behavior            emotional tone

 Stream of Talk     Concentration


 Thought Content    Cognitive-intellectual
                      functions
 Perceptual
  Abnormalities

                                               194
Intellectual Functioning

 Clear/Alert vs. Foggy/Confused
 Difficulty in Understanding
 Stream of Mental Activity
 Over Productive
 Delusions/Hallucinations




                                   195
Behavioral Reactions

 Attitude
 Controlled Behavior
 Coordination/Gait
 Distrusting/Withdrawn/Isolates Self
 Shy/Meek/Introverted




                                        196
Emotional Reactions

 Low/Depressed/Sad
 Volatile/Emotional swings
 Helpful/Motivated/Caring
 Suspicious
 Irritable/Annoyed/Angry
 Bitter
 Bullying

                              197
1.5.2.

 Summarize the usage of the L.E.A.P.S.
  concept of interaction.




                                          198
L.E.A.P.S.
 L isten

 E mpathize

 A sk

 P araphrase

 S ummarize    199
1.5.3.

 Demonstrate the process of modeling.




                                         200
Process of Modeling

 Learning through observation


 Communication/Contribute or Interfere


 Intervention/Communication strategies




                                          201
1.5.4.

 Discuss the characteristics that contribute to
  a positive communication experience.




                                                   202
Characteristics to Positive
Communication

 Introductions
 Opening Statements
 Reflecting Statements
 Methods for Gaining Trust
 Communication to Defuse




                              203
Introduction of officer to
consumer/suspect

 Identify self as officer


 Utilize Identifying Statements
   “I am (name) and I am with the (location)
      Department. I understand there is a problem
      and I would like to help you. Could you tell me
      about what happened today.”


                                                    204
Opening Statements

 Initial contact does several things:


      Establishes leadership role in conversation

      Identifies ultimate goal to resolve situation

      Allows consumer/suspect to respond with
       immediate thoughts creating dialogue
                                                       205
Continued…examples

 “Tell me what your problems are?”


 “I want to understand what you need”.


 “I understand what has happened and I want
  to help you understand the consequences.”

 “I would like to work with you to find solutions
  to your problem.”
                                                 206
Reflecting Statements

 Encourage Communication

 Neutral Responses/Encourage Talking

 Examples:
     “I see…”
     “Tell me about it…”
     “That would be one solution…”
     “What other options do you have…”

                                          207
Methods for Gaining Trust

 Honesty/Sincerity


 Follow Through


 Validation of Positive Actions


 Forewarn

                                   208
Examples…

 “I‟m not going to lie to you. You will probably
  be going to jail.”

 “You have been straightforward with me, so I
  am going to be straightforward with you…”

 “You are going to have to be handcuffed
  when you ride in the police car.”
                                                    209
Communication to Defuse

 Show understanding/empathy


 Use modeling


 Reassure


 Allow ventilation

                               210
1.5.5.

 List barriers to active communication.




                                           211
Level of Communication

 Communicate on a level that is easy for the
  consumer to understand and respond
 Keep vocabulary simple


 Example:
     “At this time, you are required to exit the
      vehicle.”        OR
     “I need you to step out of the car.”
                                                    212
Lack of Active Listening

 Arguing                   Derailing


 Criticizing               Moralizing


 Jumping to Conclusions    Name-Calling


 Pacifying                 Ordering




                                            213
1.5.6.

 Discuss three levels of active listening.




                                              214
Three Levels of Active Listening

 Listening to Words


 Listening to Whole Messages


 Reflecting the Whole Message




                                 215
1.5.7.

 Briefly explain the techniques: repeating,
  paraphrasing, and reflection of feelings as
  they relate to active listening.




                                                216
Techniques to Active Listening

 Repeating


 Paraphrasing


 Reflection of Feelings




                                 217
Repeating

 Simply restate what the person has said in his
  words
 This helps ensure you heard what you think
  you heard
 If possible…use less provocative language to
  defuse a situation
     “Blowing someone away” vs.
                     “Harming someone”
                                              218
Paraphrasing

 Go beyond what was stated in an attempt to
  understand the meaning behind the words
 Be careful not to lead with your own feelings


 Example:
 “It sounds like you are really worried about
 money right now.”

                                                  219
Reflection of Feelings

 Express awareness of other persons feelings


 Example:
  “You sound depressed….”




                                            220
Additional Techniques…

 Re-wording:
    Use this to verify shared meaning of word or
     phrase
   Redefine the situation to create the option you
     want
   Don‟t be afraid to say…
  “I don‟t know what you mean…”


                                                  221
Continued…

 Minimal Encouragers:
     Encourage communication and reinforce that
      you are listening with words like,
      “uh huh”, “yes”, “I understand” etc.

     A mixture of words and silence invites the
      dialogue to continue


                                                   222
1.5.8.

 Verbally illustrate examples of “You” vs. “I”
  statements.




                                                  223
“You” statements vs. “I” statements

 “You” statements point a verbal finger of
  accusation
  “You do not have a headache from a
  computer chip planted in your brain…”

 “I” statements establish a non-blaming tone
  “I understand your head is hurting…”

                                                224
Unit Goal: 1.6.

 To internalize the crisis intervention skills
  involved in communicating with individuals
  with a mental illness.




                                                  225
1.6.1.

 List the basic strategies that are necessary
  when communicating in crisis situations.




                                                 226
Strategies

 Stay calm                   Don‟t underestimate the
 Avoid “crowding”             power of hallucinations
 Restate
                               or delusions
                              Ask about treatment
 Use persons name
                               history
 Give instructions one at
                              Don‟t express
  a time
                               disapproval
 Engagement is pivotal




                                                     227
1.6.2.

 Describe at least four effective
  communication/interaction skills used when
  dealing with persons with a mental illness.




                                                228
Communication/Interaction Skills

 Safety


 Crisis Facts


 Language


 Movements

                                   229
Safety

 Your personal safety comes first


 Control the surroundings


 Remove harmful obstacles from the
  surroundings



                                      230
Crisis Facts

 Person in distress is usually excited, alarmed
  or confused

 Control is very important to persons in crisis


 When a person feels cornered, which
  translates to lack of control, they may
  respond with violence
                                                   231
Language

 Use person‟s name        Be patient and
  frequently                consistent

 Avoid direct             Be aware of slower
  confrontation, labels     reaction time…
  and acronyms              responses may be
                            given slower than you
 Limit number of
                            expect
  instructions

                                                    232
Movements

 Be aware of body movements


 People in crisis often need more personal
  space

 Keep movements slow and deliberate



                                              233
1.6.3.

 Apply knowledge obtained in coursework to
  class exercises and scenarios for role play.




                                                 234
Unit Goal: 1.7.

 Develop an increased understanding of the
  legal process; evaluation and techniques for
  appropriateness of apprehension.




                                                 235
1.7.1.

 List the process in evaluating the
  appropriateness of a warrentless
  apprehension.




                                       236
“Least Restrictive Alternative”

The treatment that…

 Provides the consumer with the greatest
  possibility of improvement




                                            237
Continued…

The treatment that…

 Is no more restrictive of consumer‟s physical
  or social liberties than is necessary to provide
  the consumer with the most effective
  treatment and to protect adequately against
  any danger the consumer poses to himself or
  others.

                                                  238
1.7.2.

 Describe the step by step process for
  obtaining an emergency detention order.




                                            239
Emergency Detention Order

 A statement that the officer has reason to
  believe that the risk of harm is imminent
  unless restrained.

 A statement that the officer‟s beliefs are
  derived from specific recent behavior, overt
  acts, attempts or threats that were observed
  or reliably reported.

                                                 240
Continued…

 A detailed description of the specific
  behavior, acts, attempts or threats. List who,
  what, where, when, why and how.

 List the persons name who reported
  observing the behavior and the relationship to
  the apprehended person


                                                   241
Emergency Detention Order

 Serves as a magistrates order for emergency
  apprehension and detention

 Is a civil court order issued by a magistrate


 Provides for emergency apprehension and
  transportation for evaluation

                                                  242
1.7.3.

 Explain the criteria an officer must meet in
  order to take a person with a mental illness,
  who has committed no crime, into custody
  involuntarily for emergency mental health
  evaluation.




                                                  243
Criteria…

 If the officer believes the person is mentally ill
  and as a result there is substantial risk of
  harm

 If the officer believes that if the person is not
  immediately restrained harm may occur

 Believes there is not sufficient time to obtain a
  warrant
                                                      244
1.7.4.

 Propose justification in assessing proper use
  of force options.




                                              245
Use of Force

 Keep the situation in perspective

 Force used compatible to any other person
  resisting arrest

 Force must be reasonable

 Goal is to obtain care and treatment for the
  mentally ill person
                                                 246
Continued…

 Changes in behavior intensity level are
  indicators of possible violent behavior

     Agitated Behavior
     Disruptive Behavior
     Destructive Behavior
     Out of Control


                                            247
1.7.5.

 Explain an officer‟s limitation of liability.




                                                  248
Limitation of Liability


 People acting in good faith, reasonably and without
  negligence are not civilly or criminally liable.




                         Texas health and Safety Code, Sec. 571.019(a)




                                                                     249
Confidentiality

 Communication between a patient and a
 professional, and records of the identity,
 diagnosis, evaluation, or treatment of a
 patient that is created or maintained by a
 professional are confidential.



                Texas Health and Safety Code, Sec. 611.002, 611.004


                                                                 250
Exceptions to confidentiality rule:

 Medical or law enforcement per incident


 Patient consent


 Health care personnel at Jail facility


 „Memorandum of Understanding‟

                                            251
1.7.6.

 Identify factors to be considered in
  determining whether assistance should be
  requested during an approach.




                                             252
Assistance Request Factors

 Request assistance as needed to insure
  safety of officer, consumer and public

 Contact the Mental Health Authority for
  appropriate resources and referrals




                                            253
1.7.7.

 Research departmental policies in requesting
  assistance.




                                             254
1.7.8.

 Identify factors considered in determining
  appropriate method of transporting consumer.




                                               255
Method of Transport

 Follow departmental policy


 Be aware of distances to nearest facilities


 Evaluate behavior or physical condition




                                                256
Unit Goal: 1.8.

 To explore the world of the mentally ill
  through discussion of legal and societal
  concerns and perspectives.




                                             257
1.8.1.

 Discuss the mentally ill person in a situation
  of being homeless.




                                                   258
Homeless and Mentally Ill

 Two million people are homeless per year
 On any given night, 600,000 Americans are
  homeless
 Conservative estimates state, more than one-
  third of homeless have a serious mental
  illness
 More than one-half of homeless have a
  substance abuse disorder
                                              259
New Wave of Homeless

 Emerging due to deinstitutionalization


 Emerging due to denial of services due to
  funding

 Emerging due to premature discharge due to
  managed care.

                                              260
1.8.2.

 Discuss the mentally ill individual as a victim
  of crime.




                                                    261
Crime Victim and Mentally Ill

 “People with mental illness are more likely to
  be victims than perpetrators of violence.”
                            National Institute of Justice, 1996



 Why then is…Thirteen times more research
  compiled concerning the mentally ill as
  perpetrators of violent acts rather than victims
  of violent acts?

                                                                  262
Victims…continued

 Between 4-13% are perpetrators of crime
 140 times more likely to be a victim of theft
 Three million estimated victimized each year
 More than one-quarter MI persons say they
  are victimized in a year
 Eleven times higher risk than general
  population

                                                  263
Victims…

 “We don‟t think about their vulnerability to
  victimization.”
                             Alison Cook, Reuters Health


 “The effect of crime is also more destabilizing
  for a person with a mental illness.”
                                      Dr. Linda A. Teplin




                                                            264
Responding to Victim Needs

 Victim‟s need to feel safe


 Victim's need to express his/her emotions


 Victim‟s need to know what comes next




                                              265
Common Crimes

 MI children more commonly molested or
  abused

 MI adults more commonly robbed or victim of
  con artist

 MI have reportedly less chance of a
  successful prosecution
                                            266
Victim as Mentally Retarded

 Special consideration needed upon approach

 May not even know they have been
  victimized

 Easily fooled and easily vulnerable

 Need to be treated with extreme patience and
  respect
                                            267
1.8.3.

 Evaluate the stigma and societal concerns
  from a mental health consumer‟s vantage
  point.




                                              268
Stigma

 Stigma is a mark of disgrace or shame


 Such as:
     Labeling someone with a condition
     Stereotyping people with a condition
     Creating a division
     Discrimination based on a label

                                             269
Stigma Facts

 Stigmas encourage inaccurate perceptions

 The term “mental (illness)” suggests an
  illegitimate medical condition and a
  separation from a physical (illness) condition

 Stereotypes: that persons with a mental
  illness are dangerous, less competent, not
  able to work and need „institutionalized‟ to get
  better.
                                                   270
Facts…continued

 Stigma‟s fuel fear and mistrust and reinforce
  distorted perceptions

 Some people refuse treatment for “fear” of
  being labeled

 Health insurance is even more limited for
  mental illnesses than for physical illnesses
                                                  271
Myths That Support Sigma‟s

 Mental Illnesses do not effect the average
  person

 Mental Illness is an indicator of a weak
  character

 A person with a mental illness is also mentally
  retarded
                                               272
Continued…

 If you have a mental illness you are “crazy” all
  of the time

 If people with physical disabilities can cope
  on their own, people with mental illnesses
  should be able to as well

 Most people who struggle with mental illness
  live on the streets or are in mental hospitals
                                                   273
1.8.4.

 Discuss legal and societal concerns from a
  mental health consumer‟s vantage point.




                                               274
1.8.5.

 Participate in a discussion of the family
  member perspective on mental illness.




                                              275
Unit Goal: 1.9.

 Gain an understanding of mental health
  referrals/resources in the student‟s
  community.




                                           276
1.9.1.

 List the Mental Health Facilities in your area
  that can be utilized as a resource when
  encountering a subject/suspect you identify
  as having possible mental health issues.




                                                   277
1.9.2.

 Investigate possible referral/treatment
  challenges in your community.




                                            278
Referrals/Resources

 Quality and availability of programs vary by
  community

 Willingness of mental health providers to
  participate in criminal justice initiated
  programs

 There may be a lack of services which will
  make the referral process time consuming
                                                 279
Challenge

 Be aware of the potential referral challenge,
  but don‟t let it detract you from your goal of
  responding professionally and appropriately
  to any given situation




                                                   280
Unit Goal: 1.10.

 To understand how CIT techniques apply to
  all areas of crisis communication.




                                              281
What constitutes a crisis?

 According to Webster…
     “An unstable or crucial time or state of affairs
      whose outcome will make a decisive
      difference for better or worse.”

     “…takes people out of their comfort zones and
      normal coping patterns.”


                                                         282
Continued…

 “Often a crisis is precipitated by a loss of
  some sort, or a situation that threatens
  normalcy or expectations. The greater the
  threat, the more severe the crisis will be.”

 “…the crisis is the instability and threat the
  event produces. A persons response to the
  upheaval will determine in large part, the
  outcome of it.”

                                                   283
Discussion Questions:

 Is it the event itself that is the crisis or the
  person‟s response to the situation?

 What can turn the issue into a crisis?


 What makes an issue, loss, tragedy or stress
  seem like a crisis to one person but not to
  another person?
                                                     284
Contributing Factors to Crisis

 Negative personality        Poor coping
  traits                       mechanisms due to
                               background
 Unrealistic expectations
                              Faulty belief system
 Faulty sense of identity


 Disconnectedness


                                                      285
Discussion Question


 Do you have to have a mental illness to
  possess the preceding factors?




                                            286
How can officers assist?

 Acknowledge               Investigate available
  consumers feelings         referral sources

 Avoid being judgmental    Assist in focusing on
                             the positive….be
 Assist in maintaining
                             solution oriented
  realistic view




                                                     287
1.10.1.

 Define Crisis Behavior and its relevance to
  CIT training.




                                                288
Definition of Crisis Behavior

 A person suffering from a temporary
  breakdown in coping skills
 Crisis behavior differs by individual response


 Examples of Crisis Situations:
     Locked out of house   Divorce
     Lose of job           Traffic stop
     Victim of crime       Traffic accident
                                               289
1.10.2.

 Demonstrate how Crisis Intervention
  Techniques can be utilized in domestic
  disturbance situations.




                                           290
Domestic Disturbance Scenario #1

(View #5 “Disturbance” video from “Train the Trainer” course material.)




                                                                          291
Domestic Disturbance Scenario #2

(View #6 „Disturbance‟ video from “Train the Trainer” course materials)




                                                                          292
1.10.3.

 Dramatize how an intensified traffic stop
  could be better controlled by the utilization of
  crisis communication techniques




                                                 293
Scenario

 Class Role-play exercise




                            294
Unit Goal: 1.11.

 To understand jail/court related alternatives
  and referrals for persons with a mental
  illness.




                                                  295
Problem

 Increasing numbers of mentally ill consumers
  are passing through the legal system

 The largest facility for persons with a mental
  illness has become our nations jails and
  prisons



                                                   296
Problem

 Deinstitutionalization without adequate
  community support

 Over representation of mentally ill in our
  prison system




                                               297
Statistics Show…

 Only 3% of violent behavior is attributable to a
  mental disorder, however,
 16% of prisoners have a mental illness
 50% of youth in the Texas Youth Commission
  (TYC) have a mental disorder
 In 2002 TYC reported that 21% of its
  institutional population was on psychotropics
 Persons with a mental illness are arrested at
  a disproportionately higher rate
                                                298
Solutions/Alternatives to Jail

 Drug Courts
 Mental Health Courts
 Domestic Violence Courts
 Community Courts
 Jail Diversion Programs




                                 299
And…

 These courts/programs are being
  implemented to address the underlying
  issues of the consumers criminal justice
  involvement

 The aim is to link consumers with community
  based services


                                             300
1.11.1.

 Discuss the concept of mental health courts.




                                                 301
Mental Health Courts

 A collaborative survey conducted by NAMI,
  the GAINS center and COSG‟s report at least
  94 communities across the United States
  have established mental health courts as of
  June 2004.




                                              302
Research results

 One year after completing a mental health court
  program, 54% had no new arrests
 Probation violations dropped by 62%
 Three or more arrests dropped form 26% to 3% (an
  88% decline) Clark County Mental Health Court

 Eighteen months after introducing a mental health
  court, the county saved $15,000 per year by putting
  offenders in treatment instead of jail
                                   Oklahoma County Officials


                                                               303
1.11.2.

 Describe the State of Texas Jail Diversion
  Ideal.




                                               304
H.B. 2292 states:

 “The department shall require each local
  mental health authority to incorporate jail
  diversion strategies into the authority‟s
  disease management practices for managing
  adults with schizophrenia and bi-polar
  disorder to reduce the involvement of those
  clients with the criminal justice system.”


                                             305
Implementation

 Education and training of law enforcement
  personnel and the courts

 The development and utilization of Crisis
  Intervention Teams (CIT)

 Development of centralized location for
  mental health assessment without arrest for
  individuals with non-violent criminal conduct
                                                  306
Continued…

 Development of holding facility providing
  structured treatment in lieu of arrest

 Development of Linking Services


 Development of timely and effective
  screening process

                                              307
Continued…

 Development of required community support


 Development of an identified method for
  addressing housing and needed support
  services




                                              308
1.11.3.

 List two approaches to Jail Diversion.




                                           309
Two Approaches

 Pre-booking Diversion


 Post-booking Diversion




                           310
1.11.4.

 List two facts associated with the jail diversion
  concept.




                                                 311
Facts

 Nationally, nearly half of the inmates in
  prisons with a mental illness were
  incarcerated for committing a non-violent
  offense

 Over 150,000 former patients of TDMHMR
  now find themselves caught in the Criminal
  Justice System

                                               312
Facts…continued

 Calls for police service where mental illness
  is a factor make up 7 to 10% of all police
  contact

 National analyses show that a diverted
  subject had significantly lower criminal justice
  costs than the non-diverted subject


                                                  313
1.11.5.

 List benefits of Jail Diversion.




                                     314
Benefits

 Decriminalization             Reduction of inappropriate
                                  incarceration
 Overrepresentation is
  addressed                     Length of jail stay shortened


 Reduced hospitalization       Violence and victimization
                                  reduced
 Increased public safety


 Costs to taxpayers reduced



                                                              315
Unit Goal: 1.12.

 Understanding of evaluation in demonstrating
  success.




                                             316
1.12.1.

 List four components utilized in evaluating
  success rates.




                                                317
Evaluating Success

 Criminal recidivism reduced


 Relationship between Law Enforcement and
  Mental Health Professionals improved

 Reduced % of crisis referrals to hospitals



                                               318
Continued…

 Less % of consumers needing emergency
  psychiatric care

 Officer injury rate reduced


 Consumer and community safety increased



                                            319
320
For Instructors Use


 Note: Attached are additional slides for
 facilitators inclusion as needed.




                                            321
BREAK




        322
BREAK




        323
QUESTIONS?




             324
End of Day One…




                  325
326
327
Quiet….Test in Progress




                          328
TEST




       329
This Is A Test




                 330





   Scenario


               331
Role Play




            332
333
334
Group Interaction

                335
336

				
DOCUMENT INFO
Description: Law Enforcement Training in Texas document sample