Dealing with the Mentally Ill and People in

Dealing with the Mentally Ill and People in Crisis Presented to LCPD Class 42 by Peter Di. Vasto Ph. D. Police psychologist

Communicating With People In Crisis • Learn the definition of a crisis • Learn about how some people react in crisis • Learn how you can communicate with people in crisis (eg. witnesses, victims)

What is a crisis? • An event or a series of events that threatens our ability to respond effectively and find a solution

What is a crisis? • If we get to the point where we are so stressed that we don't believe we can cope with a situation any more, then we are in a state of crisis.

How to Know When Someone Is in a Crisis • People in crisis often experience – bewilderment - "I've never felt like this before" – sense of danger - "I feel nervous, scared" – confusion - "I can't think clearly" – immobility - "I feel stuck - nothing helps" – despair - "It feels hopeless"

How to Know When Someone Is in a Crisis • People in crisis often experience – anger - "How dare he die and leave me" – apathy - "I just don't care any more" – sense of urgency - "I need help now!" – feeling of unfairness - "Why should this happen to me? "

Dealing With a Crisis • Every person is different in their ability to respond to a crisis (individual differences) – age, culture, personality, intelligence, health (both physical and mental) • The nature and magnitude of the crisis – – • we “expect” people to cope with minor calamities The increasing effect of multiple predicaments – (your goldfish dying when your house burns down on the day your favorite team loses the superbowl)

Ineffective Vs. Effective Responding To A Crisis • An ineffective response to a crisis is characterized by – emotional overload, – confused thinking and – unproductive attempts at problem solving (“my goldfish just died, I think I’ll kill myself”)

Ineffective Vs. Effective Responding To A Crisis • An effective response to a crisis contains elements of – preparation, – logical thinking, – resource management, – problem solving and – new learning

Reminders • People going through a crisis often feel as though they are going crazy. Usually they are not! • Even the most 'together' person can fall apart in a crisis. • People cannot stay in crisis mode forever.

Reminders • In a crisis, people are usually very keen to change. There is a good chance that with a bit of help, people can come out of the situation having learned a lot and feeling stronger, or be in a better position than they were before.

Interviewing People In Crisis • They may be frightened or unsure of what you want • They may be uncooperative or antagonistic • They may be under the influence of drugs, alcohol, or both • They may have their own reasons to be untruthful

The First Rule of Crisis Response BE SAFE

Communicating in a Crisis • First task is to ensure your own safety • Set the stage for cooperation – Create as private an interview setting as possible, even in the middle of chaos – Be as courteous and friendly as the circumstances and your instincts dictate

Communicating in a Crisis • Scan the environment for elements of danger or risk • Act confident (command presence) • Have a plan and take an active role in directing the interview

Communicating in a Crisis • Assess the person’s immediate needs • Evaluate the person’s psychological state • The person is in your custody and you are responsible for his/her safety, as well as yours

Communicating in a Crisis • Listening for: – speech patterns – language – word choices – emotional tone – slurred speech – volume

Communicating in a Crisis • Before you can move to problem resolution, you have to know the problem

Communicating in a Crisis – Open up communication with the subject by: Active listening Active silence Use of emotional labeling

Active listening • Active listening intentionally focuses on the speaker in order to understand what he or she is saying. • As the listener, you should then be able to repeat back in your own words what they have said to their satisfaction. This does not mean you agree with, but rather understand, what they are saying.

Active Listening • First, it forces people to listen attentively to others. • Second, it avoids misunderstandings, as people have to confirm that they do really understand what another person has said. • Third, it tends to open people up, to get them to say more.

Active Silence • Communicating that we are listening • Non-verbal attending: – eye contact, – body language – nodding

Emotional Labeling • Identify emotions. – Use the person’s body language, statements, and your own feelings as ways of identifying his/her feelings.

Emotional Labeling • Label emotions – Is the emotion positive or negative? – Negative emotions: anxiety/confusion, guilt, anger, or depression. Positive emotions: love, joy, relaxed, happy, or excited – Intensity of the feeling? (0 to 100) Extremely strong, moderate, mild, extremely mild

Communicating in a Crisis • Make calm, clear and short statements

Communicating in a Crisis: How to Begin • First offer your name • Ask for identifying information- this allows you to assess sobriety, cooperativeness, communication problems and also puts the witness in familiar territory • Start with an open-ended question - “can you tell me what you saw here ? ” “ what did you see happen here? ”

Open-Ended vs. Closed-Ended Questions • Open-ended questions are broad, general questions that do not limit the response • Open-ended questions sometimes provide answers you didn’t expect “Can you tell me what happened here? ” “What did you see? ” “What seems to be the problem? ”

Open-Ended vs. Closed-Ended Questions • A closed-ended question is answered with a "yes" or a "no. " You use this question when you want to begin narrowing the conversation and getting specific answers that lead you to a conclusion or a commitment. • You can use closed-ended questions to get more specific answers

Open-Ended vs. Closed-Ended Questions • Close-ended questions identify specific information and help keep the subject on track “What time did you get here? ” “What was the man wearing? ” “Did you see if he was carrying anything in his hands? ”

Benchmark Events • Recalling events in reverse order leads to… – Triggering memory recall, which leads to… – Witnesses re-examining their memory • Recalling from a specific point forward or backward stimulates new recall

Benchmark Events • Recalling the story backwards is an excellent way to detect deception • Question all of the witness’ senses…what did they hear, smell or feel ? • Be sure to question every possible witness

The Reluctant Witness • They may be intimidated by your presence • They may be concerned about an unrelated criminal activity • They may be unsure of what you want • They may fear reprisals and may need to talk away from the scene • They may just not like cops

Dealing with criticism • Acknowledge valid criticism - “ I would be annoyed, too, if I had to wait three hours for a police officer to show up. ” • Refocus on the here and now - “ The sooner I can get this information from you, the sooner you can be on your way. ” • If the subject “wanders”, use closed-ended questions to keep him on track.

• Interrupt only if you need to get the person back on track • Use open-ended questions to get the story • Use summary statements to make sure you understood • Use closed-ended questions to fill in missing information

Police Officer as an Interviewer and First Responder • Stay on task • Steer the conversation • Tape record your interview

• If the person appears hostile, don’t get caught in a power struggle. • We don’t argue.

• Be empathic without being intrusive • Establish trust • Do not convey disbelief, but probe for confirming/conflicting data • Caution against guessing

Roadblocks to Listening • • • Preconceived ideas about the speaker Our own need to lecture, correct or belittle “Knowing the answers” Haste Discounting the speaker Not realizing what is important

Field Interviewing • • Maintain threat awareness at all times Protect yourself and others from danger Maintain and preserve the crime scene Identify suspects, witnesses, victims and do a neighborhood canvass if necessary • The insignificant may be the “missing link” • Use all your senses and your intuition

Field Interviewing • Set the stage for cooperation • Create as private an interview setting as possible, even in the middle of chaos • Separate witnesses as soon as you get to the scene • Be as courteous and friendly as the circumstances and your instincts dictate • Some people interpret friendliness as weakness, other as a threat

Interviewing victims • Victims are often in a traumatized state • Assess their immediate needs • The victim is still in your custody and you are responsible for his/her safety, as well as yours • Tape record your interview

Interviewing the elderly • The elderly may have difficulty staying focused • They are prone to shock and denial • Use outside sources, such as caretakers, to assist you if necessary

Interviewing juveniles • Remember to take their age into consideration • Juveniles may react to the uniform more than adults • S. O. P. considerations • “ A juvenile in custody should not be questioned without the presence of his parent or a responsible adult. ”

Burglary victims • Remember - what is a common call for us is a significant trauma for the victim • Discuss possible crime prevention methods • If small children are present, you may want to perform a second “debugging” search of the house to address their fears

Victims of sexual assault • Primarily female, males may present initially as having been beaten up • Age range is infancy to old age • Be empathic without being intrusive • Establish trust • Do not convey disbelief, but probe for confirming/conflicting data

Victims of sexual assault, cont. • Allow the victim to recover if she becomes upset • Do not leave the victim alone until the interview is over

Victims of sexual assault, cont. • If anyone else is in the room (nurse, advocate, family member) establish the “ground rules” for the interview before you begin • Be aware that the presence of anyone else in the room will impact the interview, with family members having the most effect

Interviewing Suspects • • Be sure to read Miranda Be sure they understand Miranda They can invoke Miranda at any time They can revoke Miranda at any time Spontaneous utterances are admissible Tape record the interview If in doubt, especially regarding mental capacity, call a supervisor

Canvassing • Interview pedestrians and neighbors • You may want to return to the scene at the same time on another day to find joggers, mail carriers, etc • Inquire at homes and businesses • Check for other related calls in the area

Summary • Communicating with people in crisis requires active listening in collecting all information. Active silence and emotional labeling fosters trust in your interaction with them. Be aware of their condition and of your roadblocks that might hamper collection of details • Always be safe, scan the environment, size up your witnesses, and tape record