Crisis Intervention

Question 1

What type of situations in which law enforcement uses unnecessary, excessive or deadly force duiring encounters with the individuals in a mental health crisis is the problem of mental health as it pertains to law enforcement.

Answer 1

Re-occurring

Question 2

What act was passed the made changes to the CIT course?

Answer 2

Sandra Bland Act

Question 3

The CIT impact on Community is shown to ____________ impact officer perceptions, decrease the need for higher levels of police intervention, decrease officer injuries, and re-direct those in crisis from the criminal justice system to the health care system.

Answer 3

Positively

Question 4

Crisis is defined as a ____________ attack of painm distress, or disordered function or an emotionally siginifcant event or radical change of status.

Answer 4

paroxysmal

Question 5

The following type of events might result in a person feeling as though he/she is in a crisis situation.

Answer 5

Death of a loved one
Death of a pet
Getting locked out of house or car
Laid off from work or terminated
Financial difficulty
Divorce, Separation
Legal difficulties

Question 6

A mental ilness is a condition that impacs a person’s thinking, feeling or mood and may affect his or her ability to relate to others and function on a daily basis. Each person will have _____________ experiences, even people with the same __________

Answer 6

Different
Diagnosis

Question 7

According to the Texas Penal Code, secton 8.01, Insanity “is an *_______ * * __________ * to prosecution that, at the time of the conductt charged, the actor, as a result of severe mental disease or defect, did not know that his conduct was wrong.

Answer 7

arrirmative defense

Question 8

A sharp dividing line between ________ and _________ behavior does not exist and is often based upon social norms for specific societies, cultures, and subcultures.

Answer 8

normal
abnormal

Question 9

in 2015, there were an estimated _____ million adults aged 18 or older in the US with mental illness within the past year. This number represented 17.9% of all U.S. adults, or * ________* .

Answer 9

43.4

Question 10

Unfortunately, nearly two-thirds of all people with a diagnosable mental illness do not seek treatment. Stigma is a mark of disgrace or shame. It is made up of various components, including:

Answer 10

o Labeling someone with a condition
o Stereotyping people with that condition
o Creating a division (a superior ‘us’ and a denigrated ‘them’)
o Discriminating against someone based on a label

Question 11

What percentage of violent acts can be attributed to individuals living with a serious mental illness.”

Answer 11

3% - 5%

Question 12

Medication can be an essential part of an effective treatment plan and is often used to treat some of the following conditions and symptoms. The term * ________* refers to any medication capable of affecting a person’s mind, emotions, and behavior.

Answer 12

psychotropic medication

Question 13

Treatment compliance is an ongoing struggle for many individuals, for reasons including:

Answer 13

o Lack of health insurance coverage
o Expense of medications
o Unpleasant side effects, including weight gain (sometimes extreme), severe constipation, sexual dysfunction, or a feeling of being dissociated, floaty, or out of sync with their body.
* Lack of access to consistent mental health treatment.
* The experience of taking medications daily for life.

Question 14

Mental Health Conditions commonly encountered by law enforcement officers are:

Answer 14

Personality Disorders
Mood Disorders
Thought Disorders
Development Disorders
Cognitive Disorders
PTSD
Substance Use Disorders
Suicidal Ideation

Question 15

A personality disorder is an __________ * ___________* of thinking, feeling, and behaving that is relatively stable (inflexible) over time, and that deviates markedly from the person’s culture.

Answer 15

enduring pattern

Question 16

Mood disorders are demonstrated by ____________ in emotional reactions and feelings. In other words, one’s emotional experience (mood) is inconsistent with his/her circumstances.

Answer 16

disturbances

Question 17

A thought disorder can include _________ or a _________ spectrum diagnosis.

Answer 17

psychosis
schizophrenia

Question 18

____________ slow down the operations of the brain and the body.

Answer 18

CNS depressants

Question 19

Hallucinogens cause the user to perceive things _________ than they appear to others.

Answer 19

differently

Question 20

Cognitive disorders include Alzheimer’s Disease and other forms of dementia, as well as Traumatic Brain Injury (TBI). Cognitive disorders consist of significant cognitive decline in one or more areas:

Answer 20

• Attention: ability to sustain attention to a task; ability to pay attention to something despite other distractions; ability to do two things at once.
• Executive function (judgment/decision making): impaired ability to plan, make decisions, hold information briefly in one’s mind (a telephone number), ability to learn from mistakes.
• Learning and memory: ability to repeat words or digits; ability to recall recent information; ability to apply information.
• Language: ability to find the correct labels or words for an object or situation; misuse of names, verbs, or other word choices; comprehension.
• Perceptual-motor: eye-hand/body coordination.
• Social awareness: identification in changes in others’ facial expression; emotional intelligence.

Question 21

TBI Causation:

Answer 21

“Caused by impact to the head, or other mechanisms of rapid movement or displacement of the brain within the skull
* TBI can occur from proximity to a blast, blunt force trauma, and penetrating injuries.
* TBI is the leading cause of death in adults under age 45 (motor vehicle accidents) and is the second leading cause of death adults over 65.

Question 22

• “Dementia is a name for a group of symptoms caused by disorders that affect the brain”

Answer 22

• It is a degeneration of mental functioning involving thinking, memory, and reasoning. Dementia severity can range from mild (some impairment in day to day living) to severe (completely reliant upon others for basic needs).

Question 23

Identify methods most effective in talking to someone with dementia.

Answer 23

• Speak clearly and concisely; resist the urge to speak loudly.
• Due to potential difficulty with language comprehension, consider using ‘yes’ or ‘no’ questions.
• If the person appears to have difficulty with verbal comprehension, you may try using nonverbal prompt and/or written prompts.
• Be patient if the subject does not immediately follow requests or commands and/or if the subject is having difficulty communicating him/herself. The subject is likely not being intentionally resistive but is likely to be acting out of fear, confusion, and may have some delusional thought processes.
• Provide reassurance of the person’s safety.
• Check for an identification bracelet, pendant, key chain, wallet card, or clothing number that may have the person’s Safe Return ID number and emergency contact.

Question 24

Autism Spectrum Disorder:
Officers in contact with these individuals will notice certain behaviors such as

Answer 24

fear of touch, repetitive behavior (such as rocking, striking themselves, or noises), insistence on routine, extreme anxiousness in new situations, and a tendency to become confused easily.

Question 25

Intellectual Disability: This disability includes deficits in the following areas:

Answer 25

intellectual and adaptive functioning (failure to meet developmental and socio-cultural standards for intellectual and personal independence standards) (DSM-V).

Question 26

Degrees of Intellectual Disability:

Answer 26

* (Average IQ = 90-109) o Borderline Intellectual Functioning: IQ 70-79 o Mild Intellectual Disability: IQ 50-69 o Moderate Intellectual Disability: IQ 35-50 o Severe Intellectual Disability: IQ 20-50 o Profound Intellectual Disability: IQ below 20

Question 27

Performance Tasks that can be utilized to help determine if a ID problem exists

Answer 27

o Ask them to read or write a simple statement. o Give directions to their home. o Tell time. o Count to 100 by multiples of five. o Define abstract terms (such as emotions or feeling terms). o Explain how to make change from a dollar.

Question 28

Post-Traumatic Stress can develop after a person is exposed to a traumatic event, including

Answer 28

actual or threatened death, injury, or sexual violence (MHA, 2017). A person may have experienced the traumatic event(s) directly or may have witnessed them occur to someone else.

Question 29

Survivor’s Guilt:

Answer 29

* Survivor’s guilt can arise when someone survives something that other(s) do not and can lead to he or she feeling that they should have been the one to die instead. * The concept was first introduced after the Holocaust.

Question 30

The term “intimate partner violence” describes

Answer 30

physical, sexual, or psychological harm by a current or former partner or spouse.

Question 31

Hyperarousal / Hypervigilance:

Answer 31

* This is the most likely symptom a LEO will encounter with a vet.

Question 32

Examples of events that can result in PTSD include but are not limited to:

Answer 32

o Physical violence (abuse, assault, physical attack, robbery, domestic violence). o Sexual violence (rape, sexual abuse, sex trafficking, noncontact sexual abuse). o Combat (civilian or military).

Question 33

Triggers: * This term refers to sensory stimuli that cause one to recall a previous traumatic memory and subsequently have a physiological reaction to a (real or imagined) threat. * This can include

Answer 33

people, places, sights, sounds, smells, and textures.

Question 34

Definition of a Moral Injury:

Answer 34

A moral injury is the damage done to one’s conscience when the person perpetrates, witnesses, or fails to prevent acts that violate that person’s morals, ethics, or codes of conduct

Question 35

Known and quantifiable suicide risk factors:

Answer 35

* Male, age 15-34. * Depression. * Substance intoxication. * Previous suicide attempts. * Feelings of hopelessness/helplessness/powerlessness. * Specific plan, intent, and means to complete the plan. * Lack of support system or connection to loved ones. * Recent loss (divorce, child custody, retirement, death of loved one, or loss of job). * Feeling one is worth more to their loved one’s dead than alive (feels like a burden to family).

Question 36

Between 2005 and 2009, “Texas lost over *_________* people to suicide, ranking suicide as the top cause of injury death for all ages in Texas

Answer 36

12 thousand

Question 37

Protective factors against suicide:

Answer 37

o Healthy support system o Not using drugs or alcohol o Connection to a spiritual faith o Employment o Financial stability o Access to local health services o Effective mental health care o Connectedness to individuals, family, community, and social institutions o Problem-solving skills o Contacts with caregivers o Cognitive flexibility o Positive coping skills o Physical and mental health

Question 38

Suicide Risk Assessment:

Answer 38

**PLAN** o Has the person been thinking of hurting or themself? o (If yes) Have they made a plan? What arrangements or preparations have been made? *** METHOD:** o Has the person decided upon a method or a location? *** MEANS:** o Does the individual have the means to carry out the plan/chosen method? *** INTENT:** o How determined is the person to follow through with their plan? o Listen for cues of doubt/uncertainty, or statements of certainty. o Do not be shy about asking questions to ascertain the level of intent, such as, “How certain are you that this is the decision you want to make?”

Question 39

Badge of Life has collected data between 2008 and 2017 and found that there is an average of how may law enforcement suicides every year?

Answer 39

130

Question 40

These are advanced modes of communication to assist in dealing with someone in a crisis. This is a three-phase process:

Answer 40

o Safety – of the public, the subject, and the police o Stability – attempt to stabilize the person through verbal and non-verbal de-escalation skills o Problem solving - Try to get the person into a rational frame of mind (lessen emotional reactivity). Increases the likelihood of future compliance and resolution

Question 41

This quick assessment can be used to roughly determine a subject’s mental health status:

Answer 41

* 1. **Level of comprehension** o Does the person understand what you’re saying? o Can the person follow instructions? o Is person able to answer basic questions related to orientation (i.e. person, place, time)? o When person speaks do their comments make sense related to the circumstances? o How is the person speaking (quickly, slowly, slurred, mumbled)? * 2. **Behavior** o How is the person practicing basic self-care (Disheveled, dressed appropriately for season)? o Is the person caring for hygiene (bathing)? o When was the last time the person ate or drank anything? o How is the person’s physical coordination? o Compliant or non-compliant? If non-compliant, could it be due to mental health issues? * 3. **Emotion** o What is the prevailing emotional state? (anger, sadness, euphoria, anxious) o Is the emotional state appropriate to the context of the situation? o Does the person exhibit quickly fluctuating emotional expressions? (laughing to crying)

Question 42

When building rapport and trust, what are some good tatics?

Answer 42

Honesty and sincerity are essential for rapport and trust.

Question 43

Tactical Transparency:

Answer 43

This refers to explaining an action before initiating it, so the person with whom you are interacting knows what to expect.

Question 44

Examples of Crimes of which people with mental illness are commonly victims:

Answer 44

* Children with mental illness may be more vulnerable to molestation or abuse. * Their report may be less likely deemed valid or reliable by authority figures. * These victims may have greater difficulty identifying a behavior as abusive. * These victims may have difficulty identifying the perpetrator. * These victims may not have the ability to provide enough qualitative evidence (report) leading to a conviction. * Adults with a mental illness, may be easily robbed or become a victim of a con artist.

Question 45

Pre-arrest Diversion -

Answer 45

Diverting someone from the criminal justice system (no arrest or charges made), and guiding them toward a different form of intervention: o Mental health treatment facility o Hospital - This may be a good option for a first-time, low-level offender who would only be further hampered by having an arrest record.

Question 46

Mental Health Court as a form of diversion.

Answer 46

* “A type of court that combines judicial supervision with community mental health treatment and support services in an effort to reduce criminal recidivism; improve quality of life of people with mental illnesses and increase their participation in effective treatment; and to reduce court-and corrections-related costs

Question 47

Referrals to mental health courts typically come from

Answer 47

defense attorneys, judges, jail staff, or family members.

Question 48

Emergency Detention Order is considered a

Answer 48

Civil Court order issued by a magistrate