Download Personality Disorders

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)
 Ft. Wayne (IN)
 Houston (TX)
 Jackson County (MO)
 Kansas City (MO)
 Albuquerque (NM)
 Arlington (TX)
 Athens-Clarke County (GA)
 Austin (TX)
 Knoxville (TN) Minneapolis
(MN)
 Montgomery County (MD)
 New London (CT)
 San Jose (CA)
 Seattle (WA)
 Lee’s Summit (MO)
 Lincoln (NE)
 Little Rock (AR)
 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
5
14
39
50
51
Nevada
Alaska
Florida
Texas
New York
Wash. D.C.
22.3
15.5
13.4
10.0
6.6
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
Behavior
 Affect-prevailing
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
or delusions
 Ask about treatment
history
 Don’t express
disapproval
 Restate
 Use persons name
 Give instructions one at
a time
 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
frequently
 Avoid direct
confrontation, labels
and acronyms
 Limit number of
 Be patient and
consistent
 Be aware of slower
reaction time…
responses may be
given slower than you
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 onethird 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
traits
 Poor coping
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
consumers feelings
 Avoid being judgmental
 Assist in maintaining
 Investigate available
referral sources
 Assist in focusing on
the positive….be
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
Lose of job
Victim of crime
Divorce
Traffic stop
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
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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
 Reduced hospitalization
 Length of jail stay shortened
 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