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Dealing with Mentally Ill People (one in five adults)
Peace Officers are taught to communicate....
This is a summary of the Crisis Intervention Training Course.
This is a summary of the Crisis Intervention Training (CIT) given to peace officers. CIT teaches how to deal with the mentally ill, but is useful in dealing with difficult people. Remember, the person you are dealing with may have a form of mental illness.
According to the National Institute of Mental Health about 22.1% of the U.S. adult population (about one in five adults) suffers from a diagnosable mental disorder in a given year. This is an understatement of the number of persons with mental health problems, as many people do not seek treatment. Some studies indicate that 32% of U.S. adults suffer from some sort of mental illness within their lifetime.
Control paradox: by using a less confrontational, less controlling approach you end up having more control over the person.
Actually only one in four people have some kind of mental illness in their lives.
National Law Enforcement Policy Center statement
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.
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 vent.
Excessively emotional or even violent outbursts are often of short duration. It is better to let the outburst dissipate rather than wrestle with a person who is under extreme emotional stress. Bizarre behavior alone is not reason for physical force.
What works best and what is most beneficial is patience and communication.
Communicate to defuse the situation.
Show understanding/empathy. Attempt to calm an agitated subject by showing an understanding of their feelings.
Use modeling. Attempt to calm by displaying your own calmness and speak slowly and evenly.
Reassure. Calm the agitated subject by easing their fears. Assure subject of their safety. You are not a threat.
Allow ventilation. Attempt to calm an agitated subject by encouraging communications and allow a person to speak.
Choose the level of communication.
Communicate on a level that is easy for the subject to understand or respond.
Use similar words.
Do not talk over the subjects' head, keep it simple.
Lack of Active Listening
Arguing. Avoid creating or furthering a conflict.
Criticizing. Avoid making the person feel worse.
Jumping to conclusions. Do not tell the person what you think the problem is. Do not prejudge the situation. Investigate.
Derailing. Do not change the subject.
Name calling. Do not resort to derogatory names.
Ordering. Avoid an authoritative approach. Control Paradox: by using a less authoritative, less confrontational, less controlling approach you end up having more control and authority over the person.
What NOT to do....
Doing it well, Listening
Repeating. Simply restate what the subject has said in his words. This helps ensure you heard what you believe you heard. If possible, use less provocative language to deescalate the situation.
Empathize. Remember the person has a different point of view. Try to discover what it is.
Ask Questions. Has this situation ever happened before? Who has helped you in the past? What was the result? Are you on medication? What kind of medication? How many milligrams and how many times a day?
Re-wording. Use this to determine whether your meaning for a word or phrase is the same as the subject's. Redefine the situation to create the option you want. You may say, "I don't know what you mean."
Paraphrasing. Go beyond what was stated in an attempt to understand the meaning behind the words.
Summarize. Restate what is said, with fewer less hostile words.
Reflection of feeling. Express awareness of the other person's feelings. "You sound depressed."
Minimal Encouragers. Words like "uh-hunh," "yes," "I understand," etc. encourages communication and reinforces you are listening. A mixture of these words and silence also invites an individual to continue in a dialogue.
THREE SECOND ASSESSMENT
Survey the Scene: Look left a second, right a second and then at subject. Look for Hazards, Clues to Problem
Appearance: Neat or dirty, mannerisms
Stream of Speech: Ordered or disordered
Thought Content: Delusions?
Perceptual abnormalities: Hallucinations
Emotional Tone: Joyful or depressed, fearful
Concentration: Recite the months or alphabet
Cognitive Function: Alert or dull
Behavioral Reactions: General attitude, cooperative or belligerent.
Avoid arguing or criticizing
Avoid “You” statements
Avoid jumping to conclusions
Avoid judging or ordering
Do listen both to the meaning of the words and the whole message (content and feelings)
Try to understand their situation
Try to ascertain their feelings
“You seem to be feeling _____________.”
What is your name?
Prior psychiatric history, medication
Ask, “What has worked in the past?”
Find out about their family or caregiver
Ask about their chaplain or counselor
Restate their words but with reduced hostility level.
Restate situation with fewer words. Use a lower sense of urgency.
Audit a CIT Course
Audit a Crisis Intervention Training Course with your local police and learn how to communicate more effectively. Remember, the person you are dealing with may be mentally ill. Teach your family to be better communicators.