4013 Recognizing and responding to individuals in mental health crisis Flashcards
Mental illness is…
- A diagnosed/undiagnosed illness
- creating a problem in the areas of thoughts, emotional regulation, and/or behavior that reflects dysfunction
______ is a dysfunction that negatively affects someone’s thoughts, emotions, and/or behaviors and interferes in their ability to live a full life in society.
Mental illness
What situation is not considered a mental disorder?
A response to an extreme stressor, such as a loss, that is expected and culturally approved
Stress created during a mental health crisis can often lead to abnormal behaviors in the mentally ill, often requiring _____.
Law enforcement assistance
It should be noted that someone displaying a mental illness, abnormal behavior, or in crisis, does not mean….
They are involved in criminal activity
What are 3 ways Generalized neurodevelopment disorder is characterized by?
- characterized by a lower-than-average general intellectual functioning (i.e., an IQ of approximately 70 or below).
- two or more adaptive behaviors that affect everyday life (i.e.. cooking, cleaning, bathing, dressing).
- requires assistance with daily activities.
(Lifelong condition - treatment but no cure)
Ranges in severity from a handicap that somewhat limits an
otherwise normal life to a devastating disability that may require institutional care.
(Lifelong condition)
Autism
What may also be referred to “Elopement, Bolting, Fleeing, or Running?”
* Officers should know to ask “Has the child/adult ever run away before?”
Wandering - Autism
Brain Deterioration: A gradual loss of intellectual abilities.
- may have better memory of past events, seem to be living in the past.
- individual may appear lost and/or unable to recognize people
- hallucinations
- delusions
Dementia
What disease is an example of dementia?
Alzheimer’s is a type of dementia that affects memory, thinking and behavior Symptoms eventually grow severe enough to interfere with daily tasks
How to interact with someone with dementia?
- Attempt to gain rapport
- Approach slowly
- Speak slowly
- Confrontation or correcting them about time or place may prove counter-productive and should be avoided
What are 2 recognized trauma and stress-related disorders?
- Acute Stress Disorder (ASD), lasts less than a month
- Post Traumatic Stress Disorder (PTSD), lasts more than one month.
Many _____, _____, _____, and _______ can cause behaviors that can be mistaken for mental illnesses.
Medicines, illegal drugs, alcohol, and cannabis
When an officer suspects an overdose or is uncertain, it is necessary to do what?
Call emergency medical services immediately!
Recognizing possible indicators of mental illness/abnormal behavior.
Behavioral cues can include:
- bodily movement (tics, pacing, agitation, sudden jerking movements, etc.).
- lethargic, sluggish movements.
- confusion about or unaware of their surroundings.
- lack of or inappropriate emotional response.
_____ is a behavioral, emotional, or psychiatric situation likely resulting in significantly reduced levels of functioning in:
* primary activities of daily living
* often resulting in placement of the recipient in a more restrictive setting (in an emergency), including but not limited to inpatient hospitalization
Mental health crisis
Behavior violates a norm in society, is maladaptive, is rare or unusual given the context of the culture and location and causes a person stress in their daily life.
Abnormal/Atypical behavior
____ is what you are seeing from the individual when you arrive on scene and interact with the individual
Signs
_____ are what they are telling you they are experiencing or feeling
Symptoms
Trouble expressing oneself in speech. Maybe eager to communicate but has difficulty finding the right word. Grammar structure is below age level.
Expressive Language Disorder
This is a disturbance in verbal fluency
Stuttering
Can comprehend speech, also, the person tends to have a substantial vocabulary. The disorder is apparent in the person’s speech pattern. For example, blue comes out as “bu,” and rabbit sounds like “wabbit.”
Phonological Disorder
Disability that causes
impairment of understanding and language expression
Mixed Receptive-Expressive
_____ occur when a person exhibits depression. bipolar disorder (Manic depression) or both in an alternating fashion
Mood disorders
Officer response considerations for people with Bipolar disorder:
- Don’t be afraid to ask if the person is suicidal
- Don’t take the individuals mood or comments personally
- Stick to the issue at hand
The changes can occur SUDDENLY!
_____ is the act of intentionally causing one’s own death.
Suicide
Examples of life situations that can lead to suicide:
- Death or terminal iliness of a relative or friend.
- Divorce, separation, or the breakup of a relationship
- Loss of health (real or imagined).
- Loss of job, home, money, status, self-esteem, or personal security
- Drug or alcohol misuse
Risk factors for suicide:
can include both the situations a person experience and how the person is feeling internally
What are some suicide emotional and behavioral changes?
- Overwhelming pain.
- Hopelessness.
- Worthlessness, shame, guilt, or self-hatred.
- Fear of losing control and harming themselves or others.
- Appear sad, withdrawn, tired, apathetic, anxious, irritable, or prone to angry outbursts.
- Not be performing well in school, work, or other activities.
Warning signs of suicide:
- Previous suicide attempts.
- Preoccupation with death.
- Statements like, “You would be better off without me” or “I wish I were dead”
- Development of a suicide plan, “Making out a will or giving away favorite possessions.
Characteristics of suicide:
- Experiences drastic changes in behavior, loses interest in work, school, hobbies, etc.
- Shows happiness after prolonged depression.
______ is a serious and potentially deadly medical and physiological condition involving psychotic behavior, elevated temperature and an extreme fight-or-flight response by the nervous system.
Excited Delirium Syndrome
Characteristics of Excitied Delirium Syndrome:
severe agitation, unusual strength, tolerance to significant pain and elevated body temperature.
Many “in custody deaths” are linked to _____
Excited delirium syndrome
Some cases of severe _____, ______, or ______ can result in excited delirium syndrome
Intoxication, drug abuse, or substance use disorder
Scene Assessment: plan of approach
- Immediately identify people at the scene (when safe to do so)
- Who are they/Can they assist?
- Role at the scene, are they necessary (witness; bystander, etc.) or THREAT (escalation)?
- Eliminate distractions
- Observable behaviors upon arrival
- Speech, movements or gestures
- Full body assessment (WEAPONS/Hands)
If the person is a danger to himself/herself or another person the officer should….
Take IMMDIATE enforcement actions in order to:
* stabilize the scene/subject.
* secure the scene/subject.
RECOGNIZE THE DANGER SIGNS!
- Potential for “police assisted suicide”, violence, compliance.
Rapport building is critical in most situations dealing with a person in ____
Mental health crisis
Contact with the subject:
The goal is ______ but be prepared for noncompliance
Voluntary compliance
Avoid arguing with the person if….
- the person is hallucinating
- the person is delusional
- Do NOT get caught up in their perception of reality *
Recognize possible indicators of mental illness/abnormal behavior.
Verbal cues may include:
- illogical or grandiose thoughts.
- paranoia, delusions, or hallucinations.
- talking rapidly, excitedly, or loudly.
- unusual speech patterns or extremely slow speech, pressured speech or not talking
- sub-vocals; grunting or hissing
- being argumentative, belligerent, or unreasonably hostile, threatening harm to self or others
What are 2 things to do once the scene and subject(s) are secured?
- Preserve evidence
- Interview witnesses
The officer MUST be able to articulate why the person’s behaviors are a ______
Danger to themselves or others
A state of emotional exhaustion that results from failing, wearing out, or feeling totally used up due to too many demands on one’s energy, strength, or resources.
Burnout
Managing the scene.
Taking into Custody:
- Your (Officer) safety
- Safety of others
- Individual(s) safety
- In-custody deaths (considerations)
What is Deinstitutionalization?
- moved mental health patients out of state-run “insane asylums” into federally-funded community mental health centers.
- began in the 1960’s to improve treatment for the mentally ill.
- substantially decreased the services and “beds” available to the mentally ill.
- served as a catalyst for the increase in crime rate and incarcerations during the 1960’s and 1970’s.
Disposition of the individual is critical. Assistance considerations for the individual in crisis include:
- application of state law and agency policy
- informal- officer, family or counselor involvement, crisis intervention
- formal- institution or confinement based on law, agency policy and supervisory decision
- Arrest
- Involuntary commitment
