Crisis Recognition Crisis Recognition Question to Consider What

Crisis Recognition Crisis Recognition Question to Consider What

Crisis Recognition Crisis Recognition Question to Consider What are the key challenges police officers face when dealing with persons in behavioral crisis? 2 Crisis Recognition Recognizing a Person in Crisis

3 Crisis Recognition Behavioral Crisis: A Definition An episode of mental and/or emotional distress that is creating instability or danger and is considered disruptive by the community, friends, family or the person him/herself Adapted from the Seattle Police Department 4 Crisis Recognition

How Does a Crisis Typically Occur? Precipitating event Persons perception of the event Normal methods of coping fail Resulting in Breakdown in control Inability to respond appropriately Feeling overwhelmed Adapted from Police Training Institute

University of Illinois 5 Crisis Recognition Why Should I Care? 6 People in crisis need help Crises can impact public and officer safety Its our job to serve and

protect Reflects mission, values & ethics sanctity of life Crisis Recognition Mental Illness Perception disorder Thought disorder Mood disorder PTSD 7 Emotionally Distressed

Person Adapted from Nassau County, NY Police Department Crisis Recognition Optional Video Tim Wynn, Mentor for the Philadelphia Veterans Court 8 Crisis Recognition Some Facts about People with Mental Illness

Biological illness like heart disease or cancer Nobody chooses to develop a mental illness There is no cure, but many people stabilize to live full, productive lives Medications help, but they are not perfect and there can be episodes or side-effects Adapted from Seattle Police Department 9 Crisis Recognition Mental Health Statistics

1 in 5 adults lives with a mental illness: 1 in 25 adults lives with a serious mental illness 1.1% (2.4 million adults) live with schizophrenia 2.6% (6.1 million adults) live with bipolar disorder 10.2 million adults have co-occurring mental health and addiction disorders Source: National Alliance on Mental Illness

10 Crisis Recognition Mental Health Statistics 26% of adults staying in homeless shelters live with a serious mental illness 24% of state prisoners have a mental health condition 90% of those who commit suicide have an underlying mental illness

Source: National Alliance on Mental Illness 11 Crisis Recognition Multicultural Living with a mental health condition:

12 19.3% of white adults 18.6% of African American adults 16.3% of Hispanic adults Multicultural communities typically: Mental Health Statistics Have less access to treatment Are less likely to receive treatment Receive poorer quality of care Language barriers Have lower rates of health insurance

11% of transgender individuals reported being denied care due to bias or discrimination Source: National Alliance on Mental Illness Crisis Recognition Children and Teen Mental Health Statistics 13

20% of teenagers live with a mental health condition The delay between symptoms and treatment is 10 years 37% of students with a mental health condition drop out of school 70% of youth in state and local juvenile justice systems have a mental illness Source: National Alliance on Mental Illness Crisis Recognition People with Mental Illness and the Criminal Justice System People with serious mental illness can be violent

But most people with mental illness are not, and never will be, violent Jail is often not a helpful place to get stabilized Most people, even in a behavioral crisis, respond positively to kind and patient behavior 14 Sources: National Institute of Mental Health, U.S. Department of Health and Human Services

Crisis Recognition Mental Illness Emotionally Distressed Person 15 Substan ce Abuse Alcohol Illegal drugs Synthetics Combinatio n

Adapted from Nassau County, NY Police Department Crisis Recognition Mental Illness Effects of Medicatio n Traumatic Brain Injury Medical Conditio n 16 Emotionally

Distressed Person Substan ce Abuse Adapted from Nassau County, NY Police Department Crisis Recognition Mental Illness Emotionally Distressed Person Medical Conditio n

17 Substan ce Abuse Career Financial Relationshi p Situation al Stress Adapted from Nassau County, NY Police Department Crisis Recognition Persons with Intellectual

and Development Disabilities Autism spectrum disorder 18 Most common but not usually visibly apparent Persons living with autism may engage in stimming Crisis Recognition Autistic Teen engaging in stimming 19

Crisis Recognition Persons with Intellectual and Development Disabilities Autism spectrum disorder Cerebral palsy Epilepsy Developmental delay May result in difficulties in communication, adaptive living skills, self-direction, mobility.

20 Crisis Recognition Persons with Physical Disabilities Deaf/hard of hearing Blind/low vision Muscular Dystrophy Multiple Sclerosis

Stroke Alzheimers Huntingtons Disease Head/spinal cord injury May make it difficult for people to hear, comprehend and follow directions and to respond back to you. 21 Crisis Recognition Persons with disabilities may exhibit same behaviors as EDPs Dont always assume its mental illness

Could be one of many factors or a combination of several Focus on subjects behavior 22 Crisis Recognition Another Ask the person Does the person have a mental health condition?

A physical or developmental disability? Ask Dispatch 23 Are you on medication? Do you normally see a doctor? Ask family members or friends nearby Approach Ask! Get more information, ask follow-up questions

Crisis Recognition Why do you want to know whats behind someones erratic behavior? Best approaches to help stabilize the situation What communications strategies to employ What additional resources you may need Up-front awareness and recognition are key to a safe and effective response.

24 Crisis Recognition What the encounter looks like from another perspective 25 Crisis Recognition Suicide by Cop - Content Courtesy of NYPD Detective Jeff Thompson, Ph.D. 26 Crisis Recognition Suicide by Cop

Definition: A deliberate act motivated, in whole or in part, by the subjects desire to die by suicide, which provokes the law enforcement officer(s) to act, with the result being a justifiable homicide by the officer(s). -Detective Jeff Thompson, NYPD 27 Crisis Recognition Suicide by Cop Suicide-by-Cop criteria: 1. 2. 3.

28 Voluntarily enter into a confrontation with law enforcement Communicate suicidal intent (verbal or actions) Act in a threatening manner to the police Crisis Recognition Suicide by Cop Suicide by cop is prevalent and often unpredictable Study of 700 officer-involved shootings

36% were suicide-by-cop incidents 17% of these suicides were planned 81% were spontaneous Mohandie, Meloy, and Collins. Suicide by Cop Among Officer-Involved Shooting Cases. Journal of Forensic Science (2009) 29 Crisis Recognition Suicide by Cop Suicide-by-Cop Subjects:

Ment al Illnes s History of mental illness 62% Unknown mental illness 32% Under the influence of a controlled substance 17% Intoxicated 36%

Medical Thought disorder 15% Conditi on Prior criminal history 30 66% Substan ce Abuse Emotionally Distressed Person Situatio nal Stress

Crisis Recognition Suicide by Cop Subject may be experiencing a wide range of emotions and characteristics including Anger Agitation Resoluteness Defiance Desperation

We know that when a subjects emotions are running high, their rational thought is low. 31 Crisis Recognition Suicide by Cop The Emotional-Rational Thinking Scale 32 Courtesy of Detective Jeff Thompson, NYPD Crisis Recognition

Quick There Recap could be many causes for a person to be in crisis mental illness is one of them Your priority is not to diagnose and resolve the situation its to defuse, stabilize and get help 33 Crisis Recognition Quick As Recap

emotions rise, rational thinking declines lowering their emotions helps people think more rationally Empathy, communication, respect, making a connection all about trying to get 34 voluntary compliance Crisis Recognition Thoughts? Questions? Observations? 35

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