brad natalizio village of chester. reality for village of chester p.d. 15 high street: house...

POLICE RESPONSE TO EDP’S

Brad Natalizio

Village of Chester

REALITY FOR VILLAGE OF CHESTER P.D.

15 High Street: House emotionally disturbed persons

69 Brookside Avenue: Life Choices, mental retardation, schizophrenia

3 Maple Avenue: Chester Learning Center. Students must be emotionally disturbed to qualify to get into program. Ranges from ADD, ADHD, Bi-Polar, child-hood schizophrenia

Meadow Avenue: Mental retardation


History

Police encounters with mentally ill persons first became a major issue in the late 1960’s, when a deinstitutionalization movement began.

This was a long legal battle that was designed to protect people who, were believed to be mentally ill.


History

Prior to the 1960’s the mentally ill were virtually “warehoused” in large state psychiatric hospitals in abject living conditions.

Little emphasis placed on their treatment.


History

Before the movement began, such persons had very few rights, and it was comparatively easy to confine them to harsh mental institutions for long periods.

The movement succeeded, making it more difficult to institutionalize people against their will.


History

As a result of this movement and reduced funding for mental treatment, the number of people confined to mental institutions has declined by at least half a million over the last generation.

As a consequence, police are called to respond to more situations involving mentally ill and EDP’s.


History

Most police departments in the early 1980’s made attempts to incorporate specialized approaches and specific training in how to deal more effectively with the mentally ill.


WHY IS IT IMPORTANT FOR POLICE OFFICERS TO KNOW ABOUT EDP’S?

Encounters with EDP’s are frequent and sensitive police interactions.

Dealing with people who are emotionally disturbed requires a high degree of skill and sensitivity.

In these situations, thoughtless or hasty police actions may quickly make things worse, causing EDP’s to act in ways that require officers to use force that might otherwise have been avoided.

POLICE RESPONES TO EDP’S


Most EDP calls turn out to involve people who are neither a danger to themselves or others.

Nevertheless, police are called to respond to a large number of cases that are dangerous or that, if improperly handled, could quickly become dangerous.



Police response to EDP situations requires specialized skills and training.

Knowing how to communicate verbally and non-verbally, and knowing how to intervene tactfully and sensitively can dramatically enhance the likelihood that situations involving the EDP will be resolved safely and effectively.



As police, we are responsible for getting such people to mental health professionals, but we also have other responsibilities:

We must protect the lives and safety of EDPS’s.Lives and safety of other innocent people.Lives and safety of US.


Stats

1 in 5 adults suffers from a recognized mental disorder.

About 10% of all adults may have a personality disorder.

The 3 most common disorders in order of incidence are anxiety, substance abuse, and depression

Only 1 out of 5 people with a mental disorder seek professional help.


Stats

Women tend to suffer from phobias and depression, whereas men tend to have problems with alcohol and drugs and antisocial behavior.

The rates of mental problems are higher for those under 45.

College graduates tend to be less prone to mental disorders than those who do not graduate from college.


Stats

Most people diagnosed with mental illness have never been hospitalized and do not need in-patient care.

The main reason for hospital admissions nationwide is an exacerbation of a psychiatric disorder.

At any time, almost 21% of all hospital beds are filled with people with mental illness.


Stats

Mental illness is more common than cancer, diabetes, or heart disease.

Mental illness can range from mild to severe.

Like other members of the community, mentally ill people may be professionals, office workers, laborers, homemakers, children, elderly people, or people who depend on welfare and other social services for survival.


ABNORMAL PSYCHOLOGY

Anxiety DisordersStress DisordersSomatoform and Dissociative DisordersMood DisordersSchizophreniaPersonality Disorders


Anxiety Disorders

Generalized Anxiety Disorder: Experience excessive anxiety under most circumstances and worry about practically anything.

Many individuals with this disorder experience depression as well.

Women outnumber men 2 to 1


ANXIETY DISORDERS

Phobias: Are characterized by a persistent, debilitating, and severe fear of specific objects. Person feels helpless in controlling fear.

10 to 11 % of the adults in the U.S. suffer from a phobia.

Twice as common in women as in men.


Anxiety Disorders

Panic Disorder: Experience repeated episodes of periodic, discrete bouts of panic that occur suddenly, reach a peak within 10 minutes, and gradually pass.

Symptoms of panic: palpitations of the heart, tingling in the hands or feet, shortness of breath, hot and cold flashes, trembling, chest pains, choking sensations, faintness, dizziness, and a felling of unreality.


Anxiety Disorders

Obsessive-Compulsive Disorder: A person has recurrent and unwanted thoughts, a need to perform repetitive and rigid actions.

Excessive , unreasonable, causes great distress, consumes considerable time, and interferes with daily functions.

Equally common among men and women.

Usually begins in young adulthood.


STRESS DISORDERS

Acute Stress Disorder: An anxiety disorder in which fear and related symptoms are experienced soon after a traumatic event and last less than a month.

Post Traumatic Stress Disorder (PTSD): long after the event

Event usually involves actual or threatened serious injury to the person or to a family member or friend.

Ex: combat, rape, earthquake, airplane crash


Stress Disorders

PTSD: People may be battered by recurring memories, dreams, or nightmares connected to the event.

A few relive the event so vividly in their minds (flashbacks) that they think it is actually happening again.

People will usually avoid activities that remind them of the traumatic event and will try to avoid related thoughts, feelings, or conversations.

POLICE RESONSE TO EDP’S

Anxiety Disorders

PTSD: Reduced responsiveness to events in the external world.

May lose their ability to experience such intimate emotions. May feel dazed, have trouble remembering things, may feel that their body is unreal or foreign to them.

May feel overly alter, easily startled, develop sleep problems, and have trouble concentrating.

Guilt


Somatoform and Dissociative Disorders

Somatoform Disorders: A pattern of physical complaints that is explained largely by psychosocial causes.

They believe their problems are generally medical and a change in physical functioning may occur.


Somatoform and Dissociative Disorders

Dissociative Disorders: Disorders marked by major changes in memory that do not have clear physical causes.

May be the inability to remember important personal events or information.


MOOD DISORDERS

Unipolar Depression

Bipolar Disorder


MOOD DISORDERS

Depression: A low, sad state marked by significant levels of sadness, lack of energy, low self worth, guilt, or related symptoms.

Depression may be triggered by stressful events.

Other explanations focus on biological, psychological and sociocultural factors.


Symptoms of Depression:

Feeling of emptinessLose their sense of humorCrying spellsMay have to force themselves to work, talk with friendsLack of drive, initiative, spontaneity May experience anxiety, anger, agitation Loss of desire to pursue their usual activitiesMay speak slowerLess productiveLack of energyNegative views of themselves


MOOD DISORDERS

Mania: A state or episode of euphoria or frenzied activity in which people may have an exaggerated belief that the world is theirs for the taking.

Dramatic inappropriate rises in mood to abnormally high or irritable.

People with mania seem to want constant excitement, involvement and companionship during manic episode.


MOOD DISORDERS

Bipolar Disorder: A disorder marked by altering or intermixed periods of mania and depression.

Emotional rollercoaster which shifts back and forth between moods.


MOOD DISORDERS

Unipolar disorder: Depression without a history of mania.

Normal mood of depression.

Between 5% -10% of adults in the U.S. suffer from severe unipolar depression. Women being twice as likely to suffer.


SUICIDE

A self inflicted death in which the person acts intentionally, directly, and consciously.


WHAT TRIGGERS SUICIDE?

Suicidal acts may be connected to recent events or current conditions in a person’s life.

Common triggering factors include stressful events, mood and thought changes, alcohol and other drug use, and mental disorders.


Approaching Suicidal People

Most are not acutely psychotic at the time of the attempt.

Most are depressed, the nature of their problem is usually more understandable, making them easier to communicate with.



Have feelings of hopelessness and helplessness and do not believe there is any way out of their situation.

There are many different reasons why people commit suicide.



Remember that a suicidal person may attempt to have others kill him.

“Suicide by Cop” or provoking an officer to kill a person is not uncommon.

Remain calm, displays of tension can heighten a critical situation.



Make a plan and follow it, rushing to rescue a person increases risk to all.

Be alert- crisis situations are unstable; continuously evaluate the crisis.

Remember that a suicidal person may be come homicidal.



If suicidal gestures are not apparent, ask the person about suicidal intent.

Minimize the presence of people with no need to be at the scene, including law enforcement personal.

This will reduce embarrassment as well as potential negative stimulation in the environment.



Do not make sudden moves- use physical tactics as a last resort.

Do not leave person unattended.

Do not deny the person’s suicidal feelings.

Do not rush/ pressure the person to make decisions or to abandon their suicidal plan.


SCHIZOPHRENIA

There are a wide variety of schizophrenic conditions, ranging from fairly good reality contact to major disorganization and deterioration of behavior.

Patterns of bizarre conduct

Individual may show a loss of control, often with paranoia, an inability to communicate logically, and hallucinatory behavior.


Schizophrenia

Thoughts and speech appear illogical, or loosely and incoherently connected

Unrelated attitude in conversation

Words may be combined in a meaningless string

Attention fades in and out


Schizophrenia

Severe indecisiveness and an inability to carry out normal activities

Disheveled appearance

Lack of drive or motivation

Withdrawn or absorbed in their own thoughts

Hallucinations


Schizophrenia

Paranoid thinking

Irrational belief that he is superior; has a special calling; is God

Hostility and belligerence

Repetitive movements


Schizophrenia

Incoherent and illogical patterns of thought and speech

Belief that someone is controlling their thoughts put thoughts into their head, or that people can read their thoughts


Schizophrenia

Dramatically increased or decreased body movements (characteristic of what is called catatonic schizophrenia)

Impaired impulse control


Schizophrenia

Medications that are used to treat individuals who are psychotic and/ or delusional include:

HaldolProlixinStellazineClozarilRisperdalZyprexaGeodanAbilify


PERSONALITY DISORDERS

A very rigid pattern of inner experience and outward behavior that differs from the expectations of one’s culture and leads to dysfunctions

Pattern is stable and long-lasting, and its onset can be traced back at least to adolescence or early adulthood.


PERSONALITY DISORDERS

Personality disorders are separated into 3 groups:

1. Odd or eccentric behavior2. Dramatic behavior3. High degree of anxiety


RECOGNIZING EDP’S

Recognizing and properly handling EDP’s is critical to the effectiveness of Police Officers.

EDP’s often exhibit behavior patterns and verbal indicators that seem Inappropriate, Inflexible, and Impulsive.


RECOGNIZING EDP’S

Inappropriate Physical Appearance:

Disheveled or bizarre physical appearance

Appearance that is inappropriate to the environment (ex: a person who wears shorts in winter, or a heavy coat in the summer)


RECOGNIZING EDP’S

Inappropriate Body Movements:

Strange posture or mannerisms (ex: continuously looking over ones shoulder as if being followed, maintained the same or unusual body positions for an extended period of time, pacing or agitated movements, repetitive movements, or lethargic or sluggish movements)


RECOGNIZING EDP’S

Disturbances in Perception

Responding to voices or objects that are not there

Expressions of extravagant ideas (ex: the person believes they are Dan Marino)


RECOGNIZING EDP’S

Disturbances in Perception

Hallucinations, delusions or other false beliefs.

Major memory lapses, confusion, or unawareness of people or surroundings

Rapid shifts in subject in a manner that seems incoherent.


RECOGNIZING EDP’S

DISTURBANCES IN THOUGHT

It may be hard to follow an EDP’s train of thought.

They may jump from subject to subject in a manner that appears incoherent.

Their speech may be difficult or impossible to interrupt.


RECOGNIZING EDP’S

INNAPPROPRIATE MOODS OR RAPID MOOD SWINGS

Rapid or extreme mood swings from elation to depression.

Overreacting to a situation in an overly angry or frightened manner

Speech patterns that lack the normal ups and downs of emotion, or that contain uncontrollable bursts of emotion


RECOGNIZING EDP’S

INNAPPROPRIATE MOODS OR RAPID MOOD SWINGS

Expressing feelings of persecutions (ex: expressing ideas of being harassed or threatened)

Obsessive thoughts or preoccupation with subjects such as death or guilt


RECOGNIZING EDP’S

Acting or Threatening to Cause Injury to Self or Others

Cutting self with a sharp object, causing cigarette burns on body, starving self, or expressing a desire to do the same to self or others


RECOGNIZING EDP’S

Inappropriate Decorations

Strange trimmings or inappropriate use of household items (ex: aluminum foil covering windows)


RECOGNIZING EDP’S

Inappropriate Waste or Trash

Hoarding or accumulating extraordinary amounts of household items (ex: accumulating extraordinary amounts of string, newspapers, paper bags, or trash to the extent that it becomes a safety and health hazard)

The presence of feces or urine on the floors or walls


PROPER TACTICS WHEN HANDLING EDP’S

Before arrival on scene of a possible EDP, or substance abuse incident, think TACTICS.



Gather as much information as possible prior to arrival on scene:

Whether the person is armed with weapons

Medical or psychiatric history

Location of subject (home, park, ect.)

Presence of other adults, children, friends

Whether the person is violent



Gather as much information as possible prior to arrival on scene:

Whether the person has an arrest record or history of violence

Whether the person has a history of alcohol or substance abuse

Whether other uniformed personnel are on the scene (ambulance, fire department, police)

Whether other officers know the person



Get as much information regarding the EDP as possible from family members or other present.

This might include past incidents where police have been called, hospitalizations, medications, drug and alcohol use, past suicide attempts, history of violence, availability of weapons, and/ or what triggered the current incident



One officer should assume the role of the “Contact Officer”.

The contact officer will do all of the talking with the EDP. (This prevents the confusion and agitation that might ensue as a result of too may people talking at the same time).



If you are the “contact partner”, lower you radio.

The “cover officer” will handle the radio

Coordinate your plan of action

POLICE RESPONSE TO EPD’S


Be aware of you surroundings (look for weapons, dangerous conditions, entrances, exits, ect.)

Maintain a safe distance from the EDP. When an EDP is violent, maintain a barrier between yourself and the EDP.



Respect the EDP’s personal space (personal space is defined as the amount of space an individual needs between him and you to feel safe)

Avoid attempts to intimidate or threaten EDP’s. Such techniques may work with rational criminals, but are likely to further excite EDP’s.



Do not take offense at any actions or words directed against you. Remember that you are there because EDP’s have mental health problems.

Even those who may have committed crimes may not be in control of themselves, and are not purposely trying to offend you or anybody else.

Their actions are not deliberate choices. Instead, they are the results of a psychiatric illness or other condition.



Do not rush unless necessary to protect yourself or others

Do not make sudden movements

Move deliberately and slowly

Keep a distance. DISTANCE EQUALS SAFETY

Keep a barrier between yourself and any potentially dangerous EDP



Unless there is no other way to protect yourself or others against imminent harm, avoid behavior that causes agitation

Do not lie or try to deceive. Once you break trust with an EDP, it is almost impossible to get it back

Do not try to intimidate or frighten the EDP into submission



Do not “crowd” an EDP

Do not challenge the EDP’s perceptions. These may be hallucinations or delusions, but they are real to him

Do not stare at or maintain ongoing eye contact with the EDP, who may see this as challenging or threatening



Do not act in a confrontational manner by arguing with or challenging the EDP

Remember, be empathetic and a good listener

If you are the designated “contact partner”, listen and try to maintain empathy

Act as calmly as possible



Do not surprise your partner by taking any sudden or unexpected action unless someone’s safety is in imminent danger

Take as much time as you need to avoid injury to anybody

Don’t lose this advantage by rushing or by forcing a confrontation


Communicating with EDP’s

In order to assess the situation, you may want to ask questions of the EDP.

When you try to communicate, be attentive to your tone of voice and body language.

Listen carefully, be empathetic, and avoid phrases that will trigger anger, misunderstandings, or agitation.


Communicating with EDP’S

If there is something about you or your partner’s way of talking that appears to agitate the EDP, have the officer with the best rapport be the designated contact officer

He or she will do all the talking with the EDP, while the other officer acts as the cover officer.



Determine reasons for the individuals actions

Be honest- perceptions of deceit may escalate violence and be perceived as a challenge

Listen to the person- be an active, empathetic listener



Ask simple and direct questions

Ask open-ended questions

Develop a rapport- this helps to overcome the persons fear and mistrust



Recognize and respond to physical needs

Paraphrase responses and check for understanding

Identify and communicate with the healthy aspects of the person



Continually assess the situation for danger

Maintain adequate space between you and the EDP

Be calm

Give firm, clear directions



If possible only one officer should talk to the person

Respond to apparent feelings, rather than content

Respond to delusions and hallucinations by talking about the person’s feelings rather than what he is saying



Be helpful. People, generally will respond to questions concerning their basic needs (What would make you feel safer? Calmer?

Address basic needs when appropriate (tissue, cup of coffee, ect.)



Use simple acknowledgements- this encourages further communications:

Ex: “uh huh”, “I see”

Allow sufficient time for response



Encourage the person to respond

Use calm, simple, direct instructional/ request

Restate person’s statements:ex: EDP: “I can’t sleep”

Officer: “You’re having difficulty sleeping?”



Use the term “go on” and “and then…?” as general leads

Give broad opening such as “you look like you need to talk things over with someone”

This indicates willingness to listen and relieves tension



Seek clarification and problem for specifics. This encourages talking and provides accurate information

Ex: “I’m not sure I understand, could you explain?”



Avoid expressing approval or disapproval

Discuss alternatives. This enables the person to consider options

Ex: “When you feel this depressed, what can you think of that might make you feel better?”



Use position of authority in a positive manner

Keep person talking; never reach complete closure

Stress positives, such as person’s strengths, qualities, and resources.



Respect, attentiveness, openness, acceptance and positive attitude increase effectiveness of communication

Appeal to emotions rather than intellect if you know the person is under the influence of drugs

Be quiet after asking a question; listen as carefully as you question


Communicating with EDP’s- DO NOT

Not join into behavior related to the person’s mental illness (agreeing, disagreeing with delusions/ hallucinations)

Not stare at person- This may be interpreted as a threat

Not confuse the person- One officer should interact with the person. If a direction or command is given, follow through



Not give multiple choices- Giving multiple choices increases the person’s confusion

Not whisper, joke or laugh- This increases the person’s suspicions and the potential for violence



Not deceive the person- Being dishonest increases fear and suspicion; the person will likely discover the dishonesty and remember it in any subsequent contacts

Don’t make promises/ threats that you can’t follow through on



Do not challenge the person’s delusions

Do not allow yourself to be manipulated

Avoid yes or no responses to personal questions

Do not falsely threaten arrest



Do not legalize

Do not overreact to gang language, sexual, racial, ethnic insults

Do not order, command, warn, or threaten- this creates fear/ resistance, invites testing, promotes rebellious behavior



Do not moralize, preach, or judge- this communicates a message of self righteousness.

Do not name-call or ridicule

Do not negate the seriousness of the crisis- this causes misunderstanding, evokes hostility, and causes the person to be embarrassed


POSITIONAL ASPHYXIA

Positional asphyxia is death by inability to breath because of the position of ones body.

Occurs when subject is confined or held down in probe positions, rear-cuffed, lying on their abdomens.


HOW TO AVOID POSITIONAL ASPHYXIA

1. Do not hogtie anybody2. Get people in custody off their

stomachs as soon as possible3. Do not use ropes on anybody


MHL LAWS

SEE HANDOUT


The five most frequent scenarios are as follows:

1. A family member, friend, or other concerned person calls the police for help during a psychiatric emergency.

2. A person with mental illness feels suicidal and calls the police as a cry for help.

3. Police officers encounter a person with mental illness behaving inappropriately in public.

4. Citizens call the police because they feel threatened by the unusual behavior or the mere presence of a person with mental illness.

5. A person with mental illness calls the police for help because of imagined threats.


BE SAFE


brad natalizio village of chester. reality for village of chester p.d. 15 high street: house...

Documents

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mental retardation slide

police response

police departments

history police encounters

hasty police actions

sensitive police interactions

mental treatment