Combat Veteran Domestic Crisis Response:Law Enforcement De-Escalation Options

June 17, 2009

By: Jerry Lavely, Scott Neil, and Rich Miller

Sponsored by the McCormick Foundation

NYPD Emergency Services Unit preparing for a crisis situation.

Introduction

“All combat is strengthened, but irregular warfare with its ambiguity, no end in sight feeling, and horrific targeting of civilians, which ground troops observe up close, as well as the constant 360º threat environment from unseen enemy, produces unique circumstances resulting in an unusual number of mental wound casualties.”

—Brig. Gen. David L. Grange (USA, ret.)

Since the attacks of September 11 2001, almost 1.7 million military personnel have been deployed to combat operations in Iraq and Afghanistan. Of those 1.7 million, about one third, or approximately 450,000 have been deployed multiple times.i These patriotic servicemen and women represent active duty, reserve and National Guard volunteers whose lives have been forever changed by the experiences they encountered while engaged in combat operations. Compounding this challenge is the irregular nature of this conflict—no front or rear lines—characterized by the adversary often disguising himself within the neutral population, and using asymmetric tactics such as Improvised Explosive Devices (IEDs) to wage war upon U.S. and coalition forces.

As a result, much like any war, military personnel have experienced severe stressors and trauma that manifest themselves in troubling ways and make the challenge of re-integrating into domestic society a difficult, but necessary task. Whether these manifestations are categorized classically as Post-Traumatic Stress Disorder (PTSD), or are simply the natural outgrowth of sustained combat deployments, the statistics of returning veterans facing serious re-integration challenges involve, not only the veterans and the military, but our society as a whole. On the positive side, communities welcoming back veterans can be cognizant of both documented causal distress factors and successful ways to assist returning veterans transition back to civilian life. On the negative side, society is also being cautioned of the alarming rate of veteran suicides, domestic violence, and other behavior-related infractions.

Recent media reports have highlighted the role that military service has played in police shootings, suicides, homicides and other crimes. However, these reports are reactive in nature and only highlight the sensational incident, possible causal factors, penalty and/or tragic result of the incident. Rare are the reports that suggest positive ways to isolate causal variables and provide mitigation strategies or preventive programs. Even a preliminary discussion of this issue becomes controversial and creates a defensive posture among veterans groups who do not want to improperly typecast a majority of law-abiding veterans as threats to society. However, avoiding a serious discussion and focused dialogue on real issues and statistical trends misses an opportunity to create a proactive approach to preventative programs and de-escalation strategies for those veterans who are encountering re-integration challenges and crises. And, when these opportunities are missed, an increased likelihood for flashpoints and crises persist, which increases the likelihood of isolated, and often extreme veteran incidents. Comparatively, veteran incidents are statistically lower than violent encounters within

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general population categories. In today’s all volunteer military, the demographic of service members reflects a high caliber of responsible citizens in which any elevated trend is indicative of problem issues. The increase in veteran incidents is due to the lack of successful proactive programs being in place, and represents a unique threat to law enforcement because of increased proficiency in urban combat tactics, techniques and procedures (TTPs).

Furthermore, the recent attention on veteran issues has created renewed discussions about PTSD and resulted in officials pledging increased resources for more “studies” on the issue. However, these “studies” rarely provide “solutions.” Due to the nature of the combat veteran and the underlying personal factors explored in this paper, expansive studies and programs that don’t actually reach the affected person are often ineffective. The goal of this paper is to provide a “solution” to a very important issue of veteran re-integration—law enforcement response to crisis. As awareness increases and affected communities come together, it is believed that this model for “solutions - not studies” becomes a catalyst for other effective veteran and first responder programs.

Scope

This report documents recent “converging conditions” for returning veterans indicating higher risk for stress-related disorders and difficulty readjusting to civilian life. It extrapolates these conditions to identify increasing situations whereby law enforcement personnel will be called to respond to veterans in crisis whose military training and combat experience may be hazardous to law enforcement responders. The study then identifies causal factors of military veteran stress-related conditions to provide focus areas that psychologists identify as underlying themes in many veteran related EDPs (emotionally disturbed persons). The report addresses combat-related stress conditions in its entire complexity and not just strictly measured PTSD criteria. It examines many of the causal factors in these conditions such as isolation, alienation, loss of meaning, and stigmatized approaches to treatment and juxtaposes these factors with proven hostage negotiation techniques taught by New York City Police Department’s (NYPD) Emergency Services Unit (ESU) Hostage Negotiation instructors and clinical advisors. Within this comparison, several elements emerge which can be optimized to create dialogue, rapport, and common reference points for application of negotiation and de-escalation principles. Case studies of successful application of these techniques are explored to provide a template for consideration for future training and operational use. Finally, recommendations are made to implement training techniques and operational principles for expanded utilization to counter increased risk that may be encountered by law enforcement personnel in these situations. The report also leverages research in post-combat related veteran issues to provide recommendations on preventive programs that may reduce the risk of crisis encounters due to increased peer outreach and efficacy of returning combat veterans.

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Converging Conditions

While statistics on veteran apprehensions within the criminal justice system are not currently databased, the extrapolation of veteran statistics illustrates “converging conditions” that suggests returning veterans may be at an increased risk for involvement in a domestic crisis resulting in law enforcement response. The statistical measure of the events of a crisis reflects an increase in underlying causal conditions that, when unmitigated, may lead a combat veteran towards either a personal crisis such as suicide or divorce or an increase in negative behavior such as alcohol abuse. Increased rates of suicide, divorce, domestic violence, unemployment, homelessness and substance abuse, are all manifestations of problems confronting Afghanistan and Iraq veterans. These increased rates help illustrate the “converging conditions” combat veterans are faced with.

Suicide: In 2008, the active duty Army suicide rate surged to 140 individuals – an increase of 60 percent since 2003.ii This suicide rate does not include other branches of the armed services, National Guard or reservists, yet it is the highest since statistics began being kept in 1980. It equates to approximately 20.2 per 100,000 soldiers.iii For instance, this year (2009), Fort Campbell, KY, home to the 101st Airborne Division, has had 14 suicides. Recently, monthly meetings servicewide by the highest ranking Army General Officers have been instituted to review every suicide. Risk factors, trends, lessons learned and preventive measures, such as maintaining contact with troops while changing units and reducing solitary shift work have been addressed.iv

Spousal Aggression/Divorce: Rates of divorce among active duty officers and enlisted are up significantly since 2000. These figures do not include those who have left the military, as well as National Guard and reserve troops. A study by the Journal of the American Medical Association (JAMA) reported those planning to divorce their spouse rose from 9 percent to 15 percent after combat deployment and those with anger and spousal aggression issues increased from 11 percent to 22 percent after deployment.v

Unemployment: A recent study by the U.S. Department of Labor found 11.2 percent of young veterans (18-24) were unemployed (U.S. Department of Labor, 2007). In 2007, the Associated Press revealed that 18 percent of veterans who searched for employment within one to three years after discharge were unemployed.vi

Homelessness: U.S. Department of Veteran Affairs estimated the number of homeless veterans to be 154,000. Of all homeless veterans, nearly 70 percent suffer from drug, alcohol, or mental health problems. There are nearly 50,000 homeless veterans in California (NAEH, 2007).vii

Substance Abuse: One out of four younger veterans—those most likely to have returned from the Iraq and Afghanistan wars—meets medical criteria for alcohol and

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other drug abuse or addiction (The National Center on Addiction & Substance Abuse (CASA)).viii

Stress and Causal Factors

These statistics draw attention to increasing measurable trends of domestic problems and external challenges. However, when examined as indicators of underlying emotional issues, these statistics also reflect causal factors that may be identified and addressed to mitigate returning veterans’ re-integration challenges and crises. The confluence of these external and internal factors creates the “converging conditions” facing the returning combat veteran. Thus, it is critical to explore the elements of causal factors, ranging from Post-traumatic Stress Disorder (PTSD), to emotional re-adjustment and decompression.

Combat stress and related societal adjustment issues have been an issue among warriors for thousands of years. Termed “shell shock” and exhaustion during WWI and II, PTSD has become a widely used term since the Vietnam War to capture the psychological strain many soldiers face upon encountering the stressors and aftermath of combat.ix However, by definition, PTSD is a very narrow diagnosis that must meet several specific criteria. According to section 309.81 of the Diagnostic and Statistical Manual for Mental Disorders (DSM–IV), criteria for PTSD are as follows:

309.81 DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present:

1. the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently re-experienced in one (or more) of the following ways:

1. recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.

2. recurrent distressing dreams of the event.

3. acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and

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dissociative flashback episodes, including those that occur upon awakening or when intoxicated).

4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

1. efforts to avoid thoughts, feelings, or conversations associated with the trauma.

2. efforts to avoid activities, places, or people that arouse recollections of the trauma.

3. inability to recall an important aspect of the trauma.

4. markedly diminished interest or participation in significant activities.

5. feeling of detachment or estrangement from others.

6. restricted range of affect (e.g., unable to have loving feelings).

7. sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

1. difficulty falling or staying asleep

2. irritability or outbursts of anger

3. difficulty concentrating

4. hypervigilance

5. exaggerated startle response

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E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if: Acute: if duration of symptoms is less than 3 months Chronic: if duration of symptoms is 3 months or more

Specify if: With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

As a result of this medical diagnosis, in order to be “treated” for PTSD, a psychologist will screen and evaluate a patient to ensure these criteria are met. Due to the experiential nature of the disorder, often times symptoms overlap with other conditions and PTSD is not labeled as such due to “pre-existing conditions” or other overlapping psychological issues such as depression, anxiety disorders or substance abuse/alcoholism. Numbers vary, but the average American rate for PTSD is approximately 7-8 percentx. One could concede that in a peacetime military the rate for military personnel may be slightly higher than the average American rate. However, after eight years of sustained combat operations, according to the January report of the VHA Office of Public Health and Environmental Hazards, a total of 178,483 veterans who came to VA for help were diagnosed with possible mental disorders from fiscal 2002 through September 2008. This equates to roughly 44 percent of all Iraq and Afghanistan war veterans who have sought treatment at a Department of Veterans Affairs medical facility. Of that total, 92,998 service members were diagnosed with PTSD and 63,009 were diagnosed with depressive disorders. xi

Interpretation of these statistics alone is cause for concern if one assesses that the 23 percent of those service members treated at the VA who have been diagnosed with PTSD are roughly three times the national average. However, according to the same statistics, equal numbers of veterans are also suffering from other, very similar disorders. Again, this statistical increase would be alarming with any measurable disease or disorder. However, due to several facets of the nature of “combat stress,” challenges of societal re-integration away from one’s unit and the warrior ethos, recent studies suggest that these statistics miss a large portion of similarly affected combat veterans. These veterans often decline treatment due to the stigma attached, both internally and systematically. However, those who either avoid treatment, do not get referred, or have less severe symptoms still require decompression and emotional adjustment. Less researched is an uncomfortable hypothesis that suggests that without assistance, these statistically unseen veterans could progress towards a more measurable condition by experiencing second and third order effects of their combat experiences after returning home without a PTSD diagnosis.

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One such study that reflects this hypothesis is a 2007 report published in the Journal of American Medical Association (JAMA) titled Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War. This study used data from post-deployment screenings of an initial large cohort of 88,235 US soldiers returning from Iraq who completed both a Post-Deployment Health Assessment (PDHA) and a Post-Deployment Health Re-Assessment (PDHRA) with a median of 6 months between the two assessments. From the study the following was revealed:

Soldiers reported more mental health concerns and were referred at significantly higher rates from the PDHRA than from the PDHA. Based on the combined screening, clinicians identified 20.3 percent of active duty and 42.4 percent of reservists requiring mental health treatment. Concerns about interpersonal conflict increased four-fold. Soldiers frequently reported alcohol concerns, yet very few were referred to alcohol treatment. Most soldiers who used mental health services had not been referred, even though the majority accessed care within 30 days following the screening. Of the 88,235 soldiers, 3,925 (4.4 percent) were referred for mental health care on the PDHA and 10,288 (11.7 percent) were referred on the PDHRA. Only 1013 (1.1 percent) were referred during both assessments.xii

This clearly suggests the following issues:

A. The program documents a substantial increase in mental health needs several months after return from deployment. Approximately 20 percent of active duty and 42 percent of reservists (almost half) from this statistical sample screened positive for some mental treatment six months after deployment. Note: this is from returning soldiers NOT those who have sought care at a VA hospital as in earlier statistics.

B. For these soldiers interpersonal conflict concerns—a key indicator for potential emotional and domestic issues—increased 400 percent during that 6 month period.

C. Despite positive indicators, less than 12 percent were referred for treatment after the second screening.

In addition to the complexity to screen and diagnose returning veterans, another common barrier to re-integration assistance is due to the nature of the system soldiers operate in and the culture they are a part of. Awareness of the challenging post-conflict emotional adjustment and stigma are two of the biggest deterrents to soldiers seeking support for emotional stressors. This is also captured in the JAMA study which states the following:

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“Although the majority of soldiers who used mental health services had not been referred, most who sought care did so within 30 days of screening, and this was associated with having reported mental health concerns on the questionnaire. These data suggest that the screening process may have encouraged self-referral among soldiers with symptoms that were initially not considered serious enough to warrant clinician referral. This is important because perceptions of stigma are greater among soldiers with mental health symptoms than soldiers without symptoms.”xiii

The stigma of emotional conditions among the warrior class is an issue that hinders both reporting and treatment of psychological issues. Precisely because of the nature of the combat warrior, he or she is the most reluctant in society to admit a perceived weakness or emotional instability. A 2004 New England Journal of Medicine Study found that more than 60 percent of OIF/OEF (Operation Iraqi Freedom/Operation Enduring Freedom) veterans showing symptoms of PTSD were unlikely to seek help due to fears of stigmatization or loss of career advancement opportunities (Friedman, 2004).xiv This culture has also historically impacted treatment, as colleagues and supervisors have a “suck it up” attitude. This is clearly not conducive to stemming the tide of unavoidable combat consequences with symptoms no less avoidable, or significant, than physical injury.

Perhaps the best way to view the statistical conditions outlined earlier is to see them as a reflection of a culmination of increased combat stress, re-adjustment challenges, and the consequences of various interwoven psychological conditions. Having sacrificed first in combat, these consequences reflect the sacrifice that endures after the combat experience.

PTSD Revisited

Clearly not all veterans encountering emotional conditions fall into the category of classical PTSD. Based on the diagnostic criteria and statistical analysis documented earlier, there are a large quantity of returning or recently discharged personnel who are at risk for higher incidences of stress-related behavior, substance abuse or other emotional crises. As previously stated, these statistics are not highlighted to further stigmatize patriotic veterans whose volunteer service honed leadership skills, discipline and selflessness, which often serve to counterbalance the more negative facets above. They are highlighted to accurately depict trends and conditions that may be mitigated through effectively isolating key variables and addressing underlying causal factors. It is instructive to define the nature of a person in crisis and discuss some of these variables, especially in context with law enforcement definitions and response techniques.

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Definitions and Underlying Variables

At the point of crisis for any individual, veteran or otherwise, experiencing a behavior-induced personal situation that may result in a domestic crime, suicide, or law enforcement intervention, that person is termed an “Emotionally Disturbed Person” (EDP) by NYPD and law enforcement community definition. However, reviewing this definition reveals that an EDP does not solely equate to a mentally ill or PTSD sufferer. Instead it describes an individual who is not in control of their behavior and thus equates to a spectrum of manifestations from verbal outbursts to those clinically mentally ill. According to Anthony Favara, crisis intervention and hostage negotiation expert and instructor, “since all human beings have the ability to feel and express emotion and all humans are driven by emotion, each and every individual could at one time or another be considered an EDP. If you have ever had an argument with anyone, or received news that made you elated or sad, you have been an EDP… It is only when emotions turn malignant and it influences behavior to become hurtful or violent that it presents problems.”xv

This definition is critical to addressing the implicit gap between clinically-diagnosed veterans with PTSD and other veterans who have encountered stressful combat situations and are still encountering related challenges re-integrating into domestic life. It reinforces this study’s central thesis that while not all at-risk combat veterans are mentally ill, they are experiencing an increased mixture of intense personal experiences, re-integration conditions and societal adjustment. And, due to these very recent stressors and challenges, their inherently human emotional condition runs an increased risk of moving towards the right end of the EDP spectrum if not addressed and/or decompressed.

Consequently, the underlying variables that may exacerbate the emotional condition or create a trigger event that propels returning veteran towards an EDP in crisis are essential elements to proactively assist the veteran to respond to a veteran in crisis. Since these variables can run the entire spectrum of the human experience it would be impossible to list and identify every one that could create an emotional disturbance. Clearly, ordinary domestic situations such as spousal arguments or financial instability can create conditions for emotional distress. However, it is instructive to look at common threads that military personnel experience after combat experience that often trigger intense emotional feelings. In examining these threads, some underlying variables emerge that can be isolated and addressed, both to assist veterans in transition, and to assist law enforcement responders if a crisis ensues.

While not always a diagnosis, PTSD symptoms provide the first insight into common combat emotions. Due to its association with traumatic experiences and stimuli to those experiences, PTSD criteria deliver variables to consider that may create conditions for a veteran to become an EDP. Some criteria from the DSM-IV criteria some include the following:

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A. Internal or external cues that symbolize and/or resemble the traumatic event

B. Acting or feeling that the event were recurring

C. Efforts to avoid thoughts, feelings or conversations associated with the trauma

D. Feeling of detachment or estrangement from others

E. Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children or a normal life span)

F. Irritability or outbursts of anger, difficulty concentrating, hypervigilance and/or exaggerated startle response

Thus, as indicated within the PTSD criteria, a post-trauma induced EDP may manifest behavior that covers a spectrum from depressed, withdrawn and isolated to manic, anxious and hypervigilant. In these cases the behavior is triggered by a stimuli or experience of/from traumatic event, and each person’s ability to process that event creates different behavior characteristics. Many times the emotions the veteran experiences will result in a perceived loss of control, especially when compounded by domestic challenges or stressors. These perceptions run counter to military training and performance standards. This can accelerate various negative behavior manifestations and associated actions. As discussed later in this paper, the responding officer will need to identify and address both the behavior manifestation as well as the underlying causal factor within the traumatic experience to successfully de-escalate the EDP.

Less overt are the human emotions that accompany returning veterans that experience the myriad of other conditions and factors outlined earlier. Successful psychological techniques can be employed to assist with processing the combat experience and re-integrating into non-combat life. Clinical behavioral psychologists report success when the following occurs:

A. A veteran is able to “make meaning” of his experience

B. An individual feels in control – has a sense of purpose

C. A veteran is accepting of changes and resilient towards his changing conditions (both in and out of combat)

D. A veteran receives social, peer and leadership supportxvixvii

Examining the overlap between the excerpted PTSD criteria and the successful techniques for assisting combat veterans, several key variables, or themes, emerge.

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These themes offer an excellent starting point for both assisting combat veterans, and enabling law enforcement responders to execute de-escalation strategies covered in the next section.

Key components to consider include the following:

Countering feelings of: Detachment Pride (make meaning of experience)Alienation/Isolation Social and Peer support Hopelessness with Reward sacrifice – instill purposeIrritability/Anger Refreshed ControlChange resistance Instill resiliency/Personal strength

Note: Responses in right columns are not matched individually and are meant to be interchangeable. Each one of the factors on the left may be present, but each person may be affected differently due to individual circumstances.

Law Enforcement EDP Response Principles

Prior to applying law enforcement de-escalation techniques and EDP (Emotionally Disturbed Person) principles towards a veteran in crisis, it is important to first have a basic understanding of core principles and response tactics, techniques, and procedures (TTPs) for any EDP situation. The following information is instructed and employed by the NYPD ESU (Emergency Services Unit) first responders who are continually engaged in these crisis scenarios as both SWAT and Rescue/Recovery specialists in one of the world’s most populous cities. It is important to note that during any hostage negotiation or de-escalation strategy the safety of the responding officers is paramount and no TTPs which will be covered later should jeopardize the primacy of officer safety.

A first responder may encounter a spectrum of crises when encountering an EDP, from suicide attempts to a violent crime. However, this paper has chosen the NYPD ESU’s Response to Hostage Situations guidelines as a template to highlight critical de-escalation concepts. In the interest of safety, the following chronology includes tactical considerations, but is excerpted as a starting point to consider when and how to attempt to communicate and de-escalate with an EDP in crisis. In order, the incoming responders and negotiator should do the following:

A. Gather information en-route, and upon arrival at scene.

B. Take control of scene and establish inner perimeter.

C. Secure ALL exits.

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D. Ascertain if any specialized equipment is needed. (i.e., ballistic shields, etc.

E. Continue to gather information and intelligence while units and equipment are responding.

F. With units in place and perimeter secure – attempt to establish line of communication.

G. Establish a dialogue and attempt to build rapport.

H. Enter inner perimeter by direction or escort of ESU personnel and follow all safety directions.

I. Communicate any additional needs to ESU personnel (they are responsible for safety).

J. Consult with negotiating ESU member to gather any additional and pertinent information.

K. Monitor ongoing negotiations and offer suggestions if rapport is already made.

L. If necessary transition to other negotiators as smoothly as possible and continue to build trust.

M. Negotiating release/surrender is half the job. Negotiating and coordinating “how” is the other.

N. Do not permit the EDP to control the scenario.

O. Do not make promises to EDP, or give instructions, without first discussing it with ESU/Tactical/Protective detail.

P. Once “how” has been clearly established, communicate to EDP. Do not deviate from plan and ensure EDP understands (ESU/tactical detail is establishing a tactical plan and conflict will cause safety issues). Keep instructions short and easy to follow.

Q. DO NOT move out from behind cover or from inner perimeter until ESU/Tactical protection deems “all clear” and EDP is in custody.xviii

With these guidelines in mind, for the purposes of this study, it is important to focus on a), e), g), k), and i) – namely continually gather information, communicate effectively, build rapport, and develop trust. Effective techniques for these are briefly covered as a baseline for later application for a veteran EDP scenario.

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Gather Information

It is essential to gather information on both the tactical situation and the EDP as soon as possible in the response scenario. It is also essential to continually update and synthesize other information to increase subject and situational awareness. With regard to the EDP and his or her emotional state, details regarding background, history, recent events and personal information will accelerate the ability to communicate effectively, build rapport and persuade towards de-escalation. Throughout the dialogue with the EDP, and throughout the engagement scenario, this information and awareness should be continually updated and refined.

Communicate Effectively

Effective communication on behalf of the responding officer involves active and effective listening. The officer should be cognizant of what the person feels and how he or she views things. This will allow the negotiator to show they care about what is being said and help to build rapport and trust. Do not re-hearse responses, but focus replies on what is actually being said. Despite expected distractions such as radios, other personnel, etc., remain focused on the subject and conversation. Other suggested techniques are to remain positive and encouraging, ask open-ended questions (draws more information and forces the person to explain and expand answers), paraphrase (forces EDP to listen and shows you are listening and builds rapport), label emotions (when hearing an emotionally charged statement – shows you are trying to understand them) and summarize if possible. Finally, a core concept of communication is to understand is that it takes place on both a factual and emotional level. Thus, the ability to channel all the emotion in these situations assists with controlling the behavior. Values of the EDP will also influence behavior. If one can understand the EDP’s values, the responder can gain a greater understanding of both what the EDP may be attempting to do and how to influence their behavior.xix

Build Rapport and Develop Trust

Rapport can be defined as occurring when two or more people find compatibility between themselves. Rapport is mutuality and commonality as people tend to like those who are like themselves. People also like others who share the same core values and similarities because they can relate to the same set of ideals. This similarity translates into higher comfort levels and cultivates conversation, facilitating communication flow. In an EDP situation, rapport can occur when an officer uses his communication skills to actively listen and utilize proper language to connect with the EDP. He can seek to find genuine areas of commonality to begin to deliver a sense of loyalty and connection with

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the EDP. As this happens the officer may be able to see trust develop and begin to persuade the EDP and de-escalate the situation. Keep in mind that trust in an EDP scenario is less tangible and difficult to define. Instant trust is rare and not always real. However, some trust can be established with many EDPs if proper communication and rapport-building principles are followed.xx

Applying EDP Response Principles

Applying EDP principles takes training and experience. Besides the basic principles of communication and rapport building, insight into different types of mental illness, behavior disorders and emotionally charged scenarios are invaluable to help officers anticipate what type of EDP they are dealing with, what type of dialogue may ensue and what de-escalation techniques might be most effective for each scenario. Certain types of EDPs, such as a person in a manic state, will exhibit very characteristic behavior. Attempting to communicate and interact with this type of person can be very challenging. Once discovered, instead of the officer being distracted by excitable rants and raves, the responder can proactively anticipate the behavior, improve his ability to actively listen, understand root causes and establish rapport. Ultimately the officer and negotiator will use these principles to persuade the EDP towards a non-violent, safe state. The value of training, in order to be properly equipped in these scenarios, cannot be overstated. Diffusing a confrontational and otherwise violent situation is beneficial to all involved – the officer, the EDP, the department and the community. xxi

EDP Response Principles: Applications for Veterans

As demonstrated in scenario-based training for first responders encountering any EDP profile, the ability to apply EDP response principles for veterans in crisis is also achievable. The success lies in the ability to link the most common traits of veterans in emotional crisis, rapport building communication strategies. While no veteran will have identical trigger points or confluence of root causes, when viewed through a prism of how to build rapport and trust, the table outlined earlier offers opportunity for successful application of response techniques. Once again:

Countering feelings of: Detachment Pride (make meaning of experience)Alienation/Isolation Social and Peer support Hopelessness with Reward sacrifice – instill purposeIrritability/Anger Refreshed ControlChange resistance Instill resiliency/Personal strength

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Using this information for EDP response principles one can estimate differing types of rapport building strategies that may resonate with a veteran EDP. During an event, as information is gathered on the EDP’s background and issues, and once communication is established, a veteran EDP is likely to display one or more feelings from the left-hand side on the above list. Through the techniques of active listening outlined above, a responding officer can determine how those emotions have impacted the scenario he has encountered. Through the communication process the officer can identify what type of responses from the right-hand side on the list above that may resonate with the veteran in crisis, and tailor a rapport-building communication strategy based on this information.

For instance, if a veteran has barricaded himself in a dangerous situation triggered by alienation from society, he may feel isolated, unappreciated or marginalized since his or her return. However, this alienation may also cause anger and resentment towards the military. Again, each individual’s emotional circumstance will be different, but knowledge of the EDP’s military background may assist the officer to develop rapport based on information that otherwise wouldn’t have been clearly known. Once the officer knows the veteran’s background, he has a starting point for communication on that subject and may be able to develop rapport based on known themes in the right column applied to the specifics of the individual’s communication. In this manner he can communicate to the veteran in ways that resonate. He may acknowledge the military service as a shared sacrifice the two have in common, or he may sympathize with the veteran and encourage him to regain control of his surroundings. Another component underlying these manifestations is the core values the veteran may still adhere to. Since values influence behavior, the officer may be able to both anticipate the EDP’s behavior, and find a common point of reference to persuade against a violent outcome.

Every situation is different and some veterans may be resistant to discussing service, or become increasingly irritable. Thus, active listening is key in applying, and tailoring, specific communication techniques based on the actual situation. However, knowledge of these underlying themes and responses allows the officer successful options to increase communication, develop rapport and build trust. Without these identifiers and options the officer may only have information on the critical incident at hand – usually a volatile situation where domestic hostages may be present – and miss the underlying causes. If properly understood and applied, utilizing EDP response principles towards a combat veteran may save the lives of the officers, as well as the EDP. Sometimes dialogue, rapport, and de-escalation may be as simple as beginning with “Semper Fi” from a former Marine to Marine as is the case with one of these authors in an actual EDP incident. Fortunately, not only have these principles been employed successfully, they can be also be taught in scenario-based training based on increased knowledge of veteran issues. The following case study provides a more detailed look at how veteran themes may interplay within a complex EDP crisis and enhance the ability for a successful resolution.

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Case Study

The following case study depicts how the response techniques discussed can be successfully applied in an actual situation. The incident involves an attempted suicide, however, these episodes often escalate into domestic homicides, “suicide by cop” - which puts the lives of first responders in danger, and creates danger/trauma to family members and bystanders.

The following is a true story. The name of the soldier has been withheld to respect his identity. The name itself is not important; it could be any soldier who suffers from the stress of combat.

While on duty at our training facility, our police radio broadcasted a report of a “jumper.” The 911 caller simply stated it was a large, white male sitting on the edge of a movie complex parking garage approximately six stories above the ground. The location of the complex was a short distance away. The radio went on to say that there have been numerous calls coming into the system about this situation.

Myself and another instructor immediately responded with one of our rescue vehicles. Other units with special equipment responded as well. Our unit was the first to arrive on the scene. I could see the male sitting over the edge, his head in his hands. Even from a distance he appeared quite large. We gathered our high angle rope rescue equipment and proceeded to make our way to the roof. I could hear the responding units’ sirens in a distance.

Upon arriving at the top level, I could see the male; however he placed his vehicle close to the wall he was sitting on as a barrier so no one could get close to him. I slowly made my way towards him as my partner found an anchor point to tie me in. I made it to the vehicle and was now roughly 7 – 10 feet away from him. Before I could say anything, he turned to me and said “Are you a Marine?” I answered “Excuse me…” again he said “Are you a f***ing Marine?” I softly said “No, I’m not” he answered “Then get the hell outta here; I don’t want to talk to you.” I could see the painful anger etched in every wrinkle on his face; he’d been crying.

I knew I was not going to leave this young man to succumb to his suicidal thoughts. I looked him square in the eye and responded “I may not be a Marine but, my brother was, and served in Viet Nam, my father also served during WWII.” “I understand and am deeply grateful for your service; I would also like to thank you personally, for going over there and kicking the snot out of those animals that attacked us on 9/11 and caused the World Trade Center to collapse on us…14 of my buddies never made it out alive.” “You will always have our deepest respect and gratitude.” I continued “I don’t know what has driven you to this but I’m certain this is not the answer.” “I sure wish you would tell me about it before you jump.” He looked at me with tear filled eyes and said “Your unit…you

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guys are alright…you’re like the Marines…I worked for EMS…you guys are alright.” I was relieved to hear that and was hopeful he would continue to respond to me.

He told me how proud he was to be a Marine, and that he served over in Afghanistan after 9/11. He spoke of all the circumstances that are the unfortunate reality of war. He spoke of friendships and losses. He told me how he felt betrayed by the military when they psyched him out of the service. How his family had pretty much abandoned him as well. I did my best to try to persuade him that he is not seeing the full picture and that there is another road he can take; the only thing he would have to do is take the first step in the right direction. I could sense that he wanted to believe that but had doubts. I told him that if he jumped he would never know if I was right, and the one person he has always counted on to get him through the tough times has abandoned him as well. I told him he owed it to himself to at least find out. He did not have to die today.

He was in enormous emotional pain. I had established some doubt in his mind that suicide was not the answer. However, I was not convinced he was safe from completing the act. While talking to him I saw my fellow ESU officers setting up and closing in around him. The air bag was being set up on the ground below. I managed as well to open the front door of his vehicle and step up on to the rocker panel and get my other foot into the rear window, so I would be in a better position to grab him if he decided to jump.

I continued to talk to him to distract him from all that was going on around him. I asked him if he would not mind doing me a favor. I asked him if he would bring one of his legs back over the wall, while we are talking, so that there would be no accidents. As he was bringing the leg over I jumped over the roof of the car and the other officers moved in and grabbed him as well. Thankfully, he did not fight us and was receptive to help.

At the moment it was the right move. When it comes to jumpers, you never know if the person will jump or not. If you have the opportunity to make the grab you must seize it. I will never know how the rest of this story turns out. I remain hopeful that this young soldier got the help he needed. I’m certain he is not alone.xxii

After reading this study, note how the responding officer utilized principles of establishing rapport, trust, and instilling hope, purpose, and self respect in the EDP. In the case of police officers responding to police officers, the idea of rapport and trust is more easily imagined. However, just as many reservists and guardsman are police officers in civilian life, this bond is often just as easily made when encountering a veteran EDP. The case study illuminates how expressing sentiments of respect and appreciation over similar shared sacrifices and prior military service, even among relatives, can help build rapport and trust to assist transition towards de-escalation and a non-violent outcome.

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Recommendations

The following recommendations are provided to further address the issues researched in this study.

1. Expand knowledge of when and how often veterans become EDPs. Document successful de-escalation strategies and begin to database that information so that lessons learned can be shared.

2. Create preventative peer-to-peer support programs for all returning veterans likely to encounter increased emotional stressors. Due to the stigma about treatment and other documented factors, create grassroots programs that provide assistance for veteran post conflict re-integration. Combine local and federal resources to provide effective solutions for veteran post conflict challenges.

3. Combine disparate community resources to affect veteran social and peer

support programs prior to EDP incidents. Department of Defense and VA resources will not necessarily reach recently discharged returning veterans.

4. Implement law enforcement training programs for all EDP response scenarios, including veteran EDPs.

Conclusion

The study recognizes that statistics show most veterans are less likely to commit violent crimes than statistically similar demographic groups and thus veterans should not be stigmatized as a threat to society. However, the research in this study clearly shows that the likelihood of veteran-related domestic crises has been elevated and is likely to rise until preventive programs can be properly instituted. Without these prevention and mitigation strategies the response by communities will be reactive, vice proactive, at the point of crisis. In these cases, law enforcement personnel will be tasked with responding and, due to the benefit for all involved when dealing with returning combat veterans, this increased likelihood does necessitate training and awareness of effective de-escalation strategies.

Fortunately, the findings in this report suggest these same at-risk veterans have causal variables that can be identified, isolated, and mitigated. And, due to the nature of the shared sacrifices, the responding law enforcement personnel may be the best equipped to emotionally connect with the combat veteran to de-escalate the crisis. The report strongly encourages all law enforcement departments to keep the protection of its officers as a first priority, but it is hoped that with increased awareness of effective de-

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escalation strategies, this report may anchor a starting point for local communities and police departments to explore their own options to bridge veteran issues and develop response strategies.

About the Authors

Jerry Lavely, Scott Neil, and Rich Miller are veterans with almost 50 years of combined military service.

LtCol Jerry Lavely, USAF graduated from the United States Naval Academy in 1990 and served as a Naval Aviator for 10 years prior to transferring to the United States Air Force in 2000 to fly the U-2 Reconnaissance plane. He is currently assigned to United States Special Operations Command as the Senior Representative of the National Reconnaissance Office. He holds a Master’s Degree in Strategic Intelligence from the Joint Military Intelligence College. During over 19 years of active duty service he has deployed multiple times for combat operations in Operations Enduring Freedom and Iraqi Freedom, as well as countless deployments overseas for other operational activities.

MSG Scott Neil, USA, is a career Special Forces Non Commissioned Officer and currently holds the position of Senior Enlisted Advisor to the Interagency Task Force at United States Special Operations Command. During over 20 years of experience as an Infrantryman, Ranger, and Green Beret, MSG Neil has deployed for combat operations around the globe. Since 9/11 he served in the 5th Special Forces Group as Commander’s In Extremis Force (CIF) Troop Sergeant Major. In that capacity, he was one of the first Green Berets in Afghanistan after 9/11 and conducted multiple combat deployments to Afghanistan and Iraq where he ultimately trained the Iraqi Special Forces.

Detective Rich Miller has over 20 years experience as a New York City Police Department (NYPD) Emergency Services Unit (ESU) officer. A former United States Marine, he holds NYPD ESU qualifications as a sniper, rescue specialist, SCUBA, and Tactical Weapons Instructor. Det. Miller is recognized as one of the most decorated NYPD officers on the force for valor in multiple tactical situations and rescue operations, including the World Trade Center attacks on 9/11 2001.

The views expressed in this paper are those of the authors and do not represent the Department of Defense, United Special Operations Command, United States Air Force, United States Army or New York Police Department.

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About the McCormick FoundationThe McCormick Foundation is a nonprofit organization committed to strengthening our free, democratic society by investing in children, communities and country. Through its grant making programs, Cantigny Park and Golf, museums and civic outreach program the Foundation helps build a more active and engaged citizenry. It was established as a charitable trust in 1955, upon the death of Colonel Robert R. McCormick, the longtime editor and publisher of the Chicago Tribune. The McCormick Foundation is one of the nation’s largest charities, with more than $1 billion in assets. For more information, please visit www.McCormickFoundation.org.

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i William H. McMichael, “VA Diagnosing Higher Rates of PTSD,” Army Times Online article, Posted Jan 18, 2009.

ii Ann Scott Tyson, Greg Jaffe, “Generals Find Suicide a Frustrating Enemy: As Numbers Continue to Climb, Top Officers Meet Monthly to Look for Answers,” Washington Post, 23 May 2009, p. A4.

iii William B. Brown, “Another Emerging Storm: Iraq and Afghanistan Veterans with PTSD in the Criminal Justice System,” Justice Policy Journal, Vol. 5 – No.2 – Fall 2008.

iv Tyson, Jaffe, p. A4.

v Brown.

vi Ibid

vii Ibid

viii “CASA Conference To Explore Substance Abuse Among Veterans and Active Duty Military,” PRNewswire–USNewswire, May 13th 2009. ix Barbara Webster, “Combat Deployment and the Returning Police Officer,” Institute for Law and Justice, COPS Innovations Report, U.S. Department of Justice, P. 5.

x Gary Proctor, MD, “Post Traumatic Stress Disorder,” Human Military Health Care Services, www.human-military.com/south/bene/health-wellness/Behavioral%20Health/BehavioralHealthPosttraumaticStressDisorder.asp

xi McMichael.

xii Charles S. Milliken, MD; Jennifer L. Auchterlonie, MS; Charles W. Hoge, MD, “Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War,” The Journal of the American Medical Association (JAMA), Vol. 298 No. 18, November 14, 2007.

xiii Milliken, Auchterlonie, Hoge.

xiv Brown.

xv Tony Favara, “Emotionally Disturbed Persons”, NYPD ESU, Crisis Intervention Consultants LLC handbook.

xvi Pietrzak, Johnson, and Souhwick (2009)

xvii Maj Joe Geraci USA, Interview with authors, 13 April 2009, United States Military Academy, West Point New York.

xviii Favara.

xix IBID

xx IBID

xxi Stuart M. Kirschner, PHD, and Anthony Favara, Interview with authors during NYPD training session, John Jay University, New York, New York, April 2009.

xxii Favara.