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Dealing with Mentally Ill People (one in five adults)

Updated on November 11, 2016

Peace Officers are taught to communicate....

... and use the least amount of force to effect an arrest.
... and use the least amount of force to effect an arrest.

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.

Calming techniques:

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

Active 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.

Remember: L-E-A-P-S

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.


LISTEN ACTIVELY

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)

EMPATHIZE

Try to understand their situation

Try to ascertain their feelings

“You seem to be feeling _____________.”

ASK QUESTIONS

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

PARAPHRASE

Restate their words but with reduced hostility level.

SUMMARIZE

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.

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    • vocalcoach profile image

      Audrey Hunt 

      21 months ago from Idyllwild Ca.

      I'm just beginning to see the effects of the control paradox and how this works. I could have used this knowledge years ago, however, it serves me today and I'm happy you've mentioned this. The videos are very helpful. Keeping calm and being patient is crucial during an intervention.

      This is a must-read for everyone. A big thanks to you for sharing, Jay.

    • Anna Watson profile image

      Anna Watson 

      2 years ago from Atlanta, GA

      Thank you for shai ring that, Jay.

      It's extremely useful for everybody, not just police.

    • Jay C OBrien profile imageAUTHOR

      Jay C OBrien 

      2 years ago from Houston, TX USA

      Thank you Sherry.

    • Sherry H profile image

      Sherry Haynes 

      2 years ago

      You gave the best suggestions for better communication. These tips are helpful for anybody who have to deal with people of different mental attitude and habits.

    • Jay C OBrien profile imageAUTHOR

      Jay C OBrien 

      3 years ago from Houston, TX USA

      Thanks, Anna.

    • Anna Watson profile image

      Anna Watson 

      3 years ago from Atlanta, GA

      Thank you for this article, it's very concise and informative. This is the kind of information that is useful for everybody to have.

    • Donna Suthard profile image

      Donna Suthard 

      3 years ago

      Any one foolish enough to believe a loving God would have ordered up the killing of others needs his head examined.. Krishna was not God.. God only teaches love and correction without violence! Suggested reading of "A Course In Miracles"

    • profile image

      Tamara Moore 

      3 years ago

      I really appreciated this article, and the very helpful tips, on how to keep others calm, as well as defusing the situation. I thought that the image that mentions how we might be "the one" was amusing, and made me smile :-) I once took a Volunteer Class for helping Homeless People, and some of these tips were discussed. This is excellent! Thank you!

      Tamara

    • Jay C OBrien profile imageAUTHOR

      Jay C OBrien 

      4 years ago from Houston, TX USA

      Thank you vocalcoach.

    • vocalcoach profile image

      Audrey Hunt 

      4 years ago from Idyllwild Ca.

      A very helpful presentation. The videos are excellent and educational. I think we all need to learn how to deal with mentally Ill people. It's so important to learn these techniques for being a good listener. Thank you so much. I will share this informative hub with others.

    • profile image

      Old Poolman 

      4 years ago

      Very nicely done. This is great advice for all people not just peace officers.

    • Jay C OBrien profile imageAUTHOR

      Jay C OBrien 

      4 years ago from Houston, TX USA

      Donna, all peace officers in the USA are required to take the course. This article is to suggest that civilians learn the same techniques.

    • Donna Suthard profile image

      Donna Suthard 

      4 years ago

      I am so happy you shared this information..So important how to deal with anger and mental illness! Hopefully all officers will take the course!

    • MsDora profile image

      Dora Weithers 

      4 years ago from The Caribbean

      Jay, this is a very useful article. The older I get, the more sensitive I become toward people who seem to pose a problem. Often, we are not aware of their mental state. You gave us some good suggestions to help us assess them and deal with them appropriately.

    • Jay C OBrien profile imageAUTHOR

      Jay C OBrien 

      4 years ago from Houston, TX USA

      Yes Denise, that is exactly the purpose.

    • denise.w.anderson profile image

      Denise W Anderson 

      4 years ago from Bismarck, North Dakota

      These are great suggestions for dealing with any type of person with bizarre behavior, no matter the age. I think that every parent should take a crisis intervention class, that they might be able to better communicate with their spouse and their children in difficult situations. We would have much better families!

    • Jay C OBrien profile imageAUTHOR

      Jay C OBrien 

      4 years ago from Houston, TX USA

      Every Peace Officer in the nation must take this course. This article is for civilians to take the course and learn how to better communicate.

    • Michaela Osiecki profile image

      Michaela 

      4 years ago from USA

      As someone who suffers from mental illness, so does my boyfriend, cops become a group to be feared, because you know they're not going to understand and will be aggressive/violent towards you.

    • MizBejabbers profile image

      Doris James MizBejabbers 

      4 years ago from Beautiful South

      Good advice. Too bad most police officers just don't get it. In my state police shot and killed a 107-year-old man (you read that right, 107) who went off his rocker. After all the other people left the house, all these cops had to do was go away. That was all the poor guy was asking, but they had to play the hero and shoot him because "the cops felt threatened."

      Yes the man had a gun, but if there was nobody around this rural area for him to shoot, he probably would have calmed down. Heartbreaking.

    • Donna Suthard profile image

      Donna Suthard 

      4 years ago

      Excellent, Hub! will be sharing this on Facebook! We all need to learn to spot the signs of mental illness..

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