Mental Health Crisis
True or False: Someone in a crisis from being under the influence can also look like someone in a crisis from a mental health issue.
True - many times, being under the influence can mimic mental health crisis symptoms (i.e delusional thinking, hallucinations, high emotions).
True or false: You should redirect or change topics when stuck in cyclical conversations with someone with a neurocognitive issue.
True
True or False: If someone is not following your command, that means they are ignoring you and you should use force.
False - someone seemingly not following your command does not always mean that they are not complying. It could mean that they are not hearing your command (i.e the voices in their head are too loud or distracting), they do not understand your command (someone with a DD may not understand you, trust you), etc.
True or False: Verbal de-escalation always works.
False - there are times that verbal de-escalation does not work and use of force is needed.
True or False: Dilated pupils mean that the individual is under the influence.
How do we know if someone is experiencing a mental health crisis compared to someone being under the influence?
Ask questions (have you used any substance? do you have a history of MH issues, do you take any medications for what you are experiencing, how long has this been going on, have you ever been to the hospital with these issues, etc)
How can you, as an officer, be sensory friendly to individuals with developmental disabilities?
Turn down volume on radio, turn off lights and sirens, ask unnecessary people to leave area; reduce distractions so person can focus on your questions and their responses. If the person is distracted they may appear confused or agitated; if the person seems disoriented or confused, check to see if they have a hearing aid…they may not be able to hear you
What is the first action that should be taken when you recognize someone is in a state of Hyperactive Delirium w/ Severe Agitation (aka Excited Delirium) and is not responding to verbal de-escalation?
CALL FOR THE SQUAD!
What populations would it be helpful to speak slowly and use non-complex language?
Youth, older adult, & DD
True or False: Telling the person in crisis to "calm down" and "shut up" will make the person calm down and shut up.
False - this typically tends to escalate situations... it will most likely aggravate the situation and make you lose rapport with the person.
True or False: As a law enforcement officer, it is my job to know the diagnostic criteria for mental health disorders.
False - no, it's not your job. It's your job to recognize the situation at hand, de-escalate (by engaging with the person and assessing what is going on), and resolving. But, being familiar with what these disorders look like will help know what to look for and how to respond.
Name 4 ways to find information when an adult can not cognitively provide it themselves.
Ask for identification, view medications, check the refrigerator, check calendars, look for folders/packets from local agencies, look for business cards, look for items on the person (Medical Alert bracelet/necklace), Emergency Response button, GPS tracking devices (i.e Apple AirTag, specialty shoes), cell phone, public records search
How can you identify that a person may have a developmental disability?
L.O.L (Look: physical characteristics, attire may be appropriate to weather/backwards/inside out/sensory items, assistive technology); (Observe: behaviors, such as fidgeting/pacing/stimming and repetitive behaviors, and reactions, such as yelling/social inappropriateness like being too close or too far, ignoring communication attempts, and too much or too little eye contact); Listen (is the person expressing themselves/able to be understood, overly-friendly or rude, repeating themselves, interrupting stuttering, volume/tone too loud/quiet).
What are some ways to show the individual in crisis that you are listening?
By using active listening skills (i.e short phrases (mhm, okay, right, yeah, mmm, that makes sense, I understand), repeat key phrases, asking open-ended questions to get more information, bringing emotions into the room)
You ask the individual for their name and to show you their ID, and they are seemingly not complying. What do you do?
Ask again, ask if they can hear you, consider alternate ways to communicate, consider that something is happening in their brain that is preventing them from answering.
What are the steps to intervening in a crisis with someone who is suicidal?
QPR - Question (“Are you thinking about killing yourself?”); Persuade (persuade them to stay alive, by listening to their problem and giving your full attention, do not rush to judgment, OFFER HOPE, and asking if they will come with you to help them get help); Refer (take them to someone who can help if not voluntary, or get commitment to accept help and help arrange for that help, or give referral information to get help)
If a child is being a behavioral disruption, what are two techniques you can use to help de-escalate?
Do not enter into power struggle; Do not argue; Maintain calm (even when it’s frustrating); Be clear, firm, and concise when giving directions; Offering choices will be significant in this situation; remove distractions; ask if they need something to help them as they talk with you; use simple language; validate feelings
How can you build rapport with a Veteran in crisis?
Ask questions (how long did you serve, what branch, what unit, why that branch, what did you do in the military, etc), offer help (I know another veteran who can talk to you, is there a battle buddy you can call?), LISTEN
What tone of voice should be used during a de-escalation attempt?
calm, low, and respectful
Why is CIT important?
Prevent injuries, save lives, & avoid liability, create the best outcomes for individuals in crisis.
What is it called when a person loses the ability to cope or regulate emotions effectively?
A CRISIS! Due to some kind of chemical dysfunction in the brain, the person has lost control of being able to regulate their emotions effectively and cope with the situation appropriately.
How can you offer hope to someone who is suicidal?
Persuade them to talk to someone or seek help (i.e. “I have worked with a lot of people in a lot of pain and I have seen them get through this because the pain is temporary. We have really good doctors and treatment agencies in this community and, if you let me, we can start the process of getting help right now.”); did they mention family/friends/future plans/etc that you could use as a driving force for hope
What is your strategy for responding to a Hyperactive Delirium w/ Severe Agitation (aka Excited Delirium) situation?
1) Attempt verbal de-escalation; 2) Call for EMS quickly; 3) If need use Taser before a struggle ensues; 4) Restrain the subject during Taser deployment; 5) Administer tranquillizer (Ketamine, Geodon); 6) Back off and contain the subject with minimal restraint; 7) Once calm, transport (four point restraint)
Give two examples of a non-verbal de-escalation technique.
Head nods, keeping appropriate distance, open posture, eye contact
What does a "Trauma-Informed Response" look like?
DO NOT: shame, argue, challenge, blame, order, threaten
DO: show empathy/understanding, model calm voice/talk softer, use active listening skills, meet w/ youth alone (may limit responses if caregiver is there or someone who may be cause of their trauma), reassure (I am here to help, it will be okay), respond & encourage (be conversational, change the subject by using visuals around you, "I used to watch that show when I was your age. Do you like that show?"... opens door for rapport building), guide the situation toward a resolution.