Transcript POLICE RESPONSE TO EDP’S

Brad Natalizio
Village of Chester
REALITY FOR VILLAGE OF CHESTER P.D.

15 High Street: House emotionally disturbed persons

69 Brookside Avenue: Life Choices, mental

3 Maple Avenue: Chester Learning Center. Students

Meadow Avenue: Mental retardation
retardation, schizophrenia
must be emotionally disturbed to qualify to get into
program. Ranges from ADD, ADHD, Bi-Polar, childhood schizophrenia
History
Police encounters with mentally ill persons first
became a major issue in the late 1960’s,
when a deinstitutionalization movement
began.
This was a long legal battle that was designed
to protect people who, were believed to be
mentally ill.
History
Prior to the 1960’s the mentally ill were
virtually “warehoused” in large state
psychiatric hospitals in abject living
conditions.
Little emphasis placed on their treatment.
History
Before the movement began, such persons had
very few rights, and it was comparatively easy
to confine them to harsh mental institutions
for long periods.
The movement succeeded, making it more
difficult to institutionalize people against
their will.
History
As a result of this movement and reduced
funding for mental treatment, the number of
people confined to mental institutions has
declined by at least half a million over the last
generation.
As a consequence, police are called to respond
to more situations involving mentally ill and
EDP’s.
History
Most police departments in the early 1980’s
made attempts to incorporate specialized
approaches and specific training in how to
deal more effectively with the mentally ill.
WHY IS IT IMPORTANT FOR POLICE OFFICERS TO
KNOW ABOUT EDP’S?
Encounters with EDP’s are frequent and sensitive
police interactions.
Dealing with people who are emotionally disturbed
requires a high degree of skill and sensitivity.
In these situations, thoughtless or hasty police
actions may quickly make things worse, causing
EDP’s to act in ways that require officers to use
force that might otherwise have been avoided.
WHY IS IT IMPORTANT FOR POLICE OFFICERS
TO KNOW ABOUT EDP’S?
Most EDP calls turn out to involve people who
are neither a danger to themselves or others.
Nevertheless, police are called to respond to a
large number of cases that are dangerous or
that, if improperly handled, could quickly
become dangerous.
WHY IS IT IMPORTANT FOR POLICE OFFICERS TO
KNOW ABOUT EDP’S?
Police response to EDP situations requires
specialized skills and training.
Knowing how to communicate verbally and nonverbally, and knowing how to intervene tactfully
and sensitively can dramatically enhance the
likelihood that situations involving the EDP will
be resolved safely and effectively.
WHY IS IT IMPORTANT FOR POLICE OFFICERS
TO KNOW ABOUT EDP’S?
As police, we are responsible for getting such
people to mental health professionals, but we
also have other responsibilities:
We must protect the lives and safety of EDPS’s.
Lives and safety of other innocent people.
Lives and safety of US.
Stats

1 in 5 adults suffers from a recognized mental
disorder.

About 10% of all adults may have a personality
disorder.

The 3 most common disorders in order of incidence
are anxiety, substance abuse, and depression

Only 1 out of 5 people with a mental disorder seek
professional help.
Stats



Women tend to suffer from phobias and
depression, whereas men tend to have problems
with alcohol and drugs and antisocial behavior.
The rates of mental problems are higher for
those under 45.
College graduates tend to be less prone to
mental disorders than those who do not graduate
from college.
Stats
Most people diagnosed with mental illness have
never been hospitalized and do not need inpatient care.
The main reason for hospital admissions
nationwide is an exacerbation of a psychiatric
disorder.
At any time, almost 21% of all hospital beds are
filled with people with mental illness.
Stats
Mental illness is more common than cancer,
diabetes, or heart disease.
Mental illness can range from mild to severe.
Like other members of the community, mentally ill
people may be professionals, office workers,
laborers, homemakers, children, elderly people,
or people who depend on welfare and other
social services for survival.
ABNORMAL PSYCHOLOGY
Anxiety Disorders
Stress Disorders
Somatoform and Dissociative Disorders
Mood Disorders
Schizophrenia
Personality Disorders
Anxiety Disorders
Generalized Anxiety Disorder: Experience
excessive anxiety under most circumstances
and worry about practically anything.
Many individuals with this disorder experience
depression as well.
Women outnumber men 2 to 1
ANXIETY DISORDERS
Phobias: Are characterized by a persistent,
debilitating, and severe fear of specific
objects. Person feels helpless in controlling
fear.
10 to 11 % of the adults in the U.S. suffer from
a phobia.
Twice as common in women as in men.
Anxiety Disorders
Panic Disorder: Experience repeated episodes of
periodic, discrete bouts of panic that occur
suddenly, reach a peak within 10 minutes, and
gradually pass.
Symptoms of panic:
palpitations of the heart, tingling in the hands or
feet, shortness of breath, hot and cold flashes,
trembling, chest pains, choking sensations,
faintness, dizziness, and a felling of unreality.
Anxiety Disorders
Obsessive-Compulsive Disorder: A person has
recurrent and unwanted thoughts, a need to
perform repetitive and rigid actions.
Excessive , unreasonable, causes great distress,
consumes considerable time, and interferes with
daily functions.
Equally common among men and women.
Usually begins in young adulthood.
STRESS DISORDERS
Acute Stress Disorder: An anxiety disorder in which fear
and related symptoms are experienced soon after a
traumatic event and last less than a month.
Post Traumatic Stress Disorder (PTSD): long after the
event
Event usually involves actual or threatened serious
injury to the person or to a family member or friend.
Ex: combat, rape, earthquake, airplane crash
Stress Disorders
PTSD: People may be battered by recurring
memories, dreams, or nightmares connected to
the event.
A few relive the event so vividly in their minds
(flashbacks) that they think it is actually
happening again.
People will usually avoid activities that remind
them of the traumatic event and will try to avoid
related thoughts, feelings, or conversations.
Anxiety Disorders
PTSD: Reduced responsiveness to events in the
external world.
May lose their ability to experience such intimate
emotions. May feel dazed, have trouble remembering
things, may feel that their body is unreal or foreign to
them.
May feel overly alter, easily startled, develop sleep
problems, and have trouble concentrating.
Guilt
Somatoform and Dissociative Disorders
Somatoform Disorders: A pattern of physical
complaints that is explained largely by
psychosocial causes.
They believe their problems are generally
medical and a change in physical functioning
may occur.
Somatoform and Dissociative Disorders
Dissociative Disorders: Disorders marked by
major changes in memory that do not have
clear physical causes.
May be the inability to remember important
personal events or information.
MOOD DISORDERS
Unipolar Depression
Bipolar Disorder
MOOD DISORDERS
Depression: A low, sad state marked by
significant levels of sadness, lack of energy,
low self worth, guilt, or related symptoms.
Depression may be triggered by stressful
events.
Other explanations focus on biological,
psychological and sociocultural factors.
Symptoms of Depression:
Feeling of emptiness
Lose their sense of humor
Crying spells
May have to force themselves to work, talk with friends
Lack of drive, initiative, spontaneity
May experience anxiety, anger, agitation
Loss of desire to pursue their usual activities
May speak slower
Less productive
Lack of energy
Negative views of themselves
MOOD DISORDERS
Mania: A state or episode of euphoria or frenzied
activity in which people may have an exaggerated
belief that the world is theirs for the taking.
Dramatic inappropriate rises in mood to
abnormally high or irritable.
People with mania seem to want constant
excitement, involvement and companionship
during manic episode.
MOOD DISORDERS
Bipolar Disorder: A disorder marked by altering
or intermixed periods of mania and
depression.
Emotional rollercoaster which shifts back and
forth between moods.
MOOD DISORDERS
Unipolar disorder: Depression without a history
of mania.
Normal mood of depression.
Between 5% -10% of adults in the U.S. suffer
from severe unipolar depression. Women
being twice as likely to suffer.
SUICIDE
A self inflicted death in which the person acts
intentionally, directly, and consciously.
WHAT TRIGGERS SUICIDE?
Suicidal acts may be connected to recent
events or current conditions in a person’s life.
Common triggering factors include stressful
events, mood and thought changes, alcohol
and other drug use, and mental disorders.
Approaching Suicidal People
Most are not acutely psychotic at the time of
the attempt.
Most are depressed, the nature of their
problem is usually more understandable,
making them easier to communicate with.
Approaching Suicidal People
Have feelings of hopelessness and
helplessness and do not believe there is any
way out of their situation.
There are many different reasons why people
commit suicide.
Approaching Suicidal People
Remember that a suicidal person may attempt
to have others kill him.
“Suicide by Cop” or provoking an officer to kill
a person is not uncommon.
Remain calm, displays of tension can heighten
a critical situation.
Approaching Suicidal People
Make a plan and follow it, rushing to rescue a
person increases risk to all.
Be alert- crisis situations are unstable;
continuously evaluate the crisis.
Remember that a suicidal person may be come
homicidal.
Approaching Suicidal People
If suicidal gestures are not apparent, ask the
person about suicidal intent.
Minimize the presence of people with no need to
be at the scene, including law enforcement
personal.
This will reduce embarrassment as well as
potential negative stimulation in the
environment.
Approaching Suicidal People
Do not make sudden moves- use physical tactics
as a last resort.
Do not leave person unattended.
Do not deny the person’s suicidal feelings.
Do not rush/ pressure the person to make
decisions or to abandon their suicidal plan.
SCHIZOPHRENIA
There are a wide variety of schizophrenic conditions,
ranging from fairly good reality contact to major
disorganization and deterioration of behavior.
Patterns of bizarre conduct
Individual may show a loss of control, often with
paranoia, an inability to communicate logically, and
hallucinatory behavior.
Schizophrenia
Thoughts and speech appear illogical, or loosely
and incoherently connected
Unrelated attitude in conversation
Words may be combined in a meaningless string
Attention fades in and out
Schizophrenia
Severe indecisiveness and an inability to carry out
normal activities
Disheveled appearance
Lack of drive or motivation
Withdrawn or absorbed in their own thoughts
Hallucinations
Schizophrenia
Paranoid thinking
Irrational belief that he is superior; has a
special calling; is God
Hostility and belligerence
Repetitive movements
Schizophrenia
Incoherent and illogical patterns of thought
and speech
Belief that someone is controlling their
thoughts put thoughts into their head, or that
people can read their thoughts
Schizophrenia
Dramatically increased or decreased body
movements (characteristic of what is called
catatonic schizophrenia)
Impaired impulse control
Schizophrenia
Medications that are used to treat individuals who are
psychotic and/ or delusional include:
Haldol
Prolixin
Stellazine
Clozaril
Risperdal
Zyprexa
Geodan
Abilify
PERSONALITY DISORDERS
A very rigid pattern of inner experience and
outward behavior that differs from the
expectations of one’s culture and leads to
dysfunctions
Pattern is stable and long-lasting, and its onset
can be traced back at least to adolescence or
early adulthood.
PERSONALITY DISORDERS
Personality disorders are separated into 3
groups:
1. Odd or eccentric behavior
2. Dramatic behavior
3. High degree of anxiety
RECOGNIZING EDP’S
Recognizing and properly handling EDP’s is
critical to the effectiveness of Police Officers.
EDP’s often exhibit behavior patterns and
verbal indicators that seem Inappropriate,
Inflexible, and Impulsive.
RECOGNIZING EDP’S
Inappropriate Physical Appearance:
Disheveled or bizarre physical appearance
Appearance that is inappropriate to the
environment (ex: a person who wears shorts
in winter, or a heavy coat in the summer)
RECOGNIZING EDP’S
Inappropriate Body Movements:
Strange posture or mannerisms (ex:
continuously looking over ones shoulder as if
being followed, maintained the same or
unusual body positions for an extended
period of time, pacing or agitated
movements, repetitive movements, or
lethargic or sluggish movements)
RECOGNIZING EDP’S
Disturbances in Perception


Responding to voices or objects that are not
there
Expressions of extravagant ideas (ex: the
person believes they are Dan Marino)
RECOGNIZING EDP’S
Disturbances in Perception

Hallucinations, delusions or other false beliefs.

Major memory lapses, confusion, or unawareness
of people or surroundings

Rapid shifts in subject in a manner that seems
incoherent.
RECOGNIZING EDP’S
DISTURBANCES IN THOUGHT
It may be hard to follow an EDP’s train of thought.
They may jump from subject to subject in a
manner that appears incoherent.
Their speech may be difficult or impossible to
interrupt.
RECOGNIZING EDP’S
INNAPPROPRIATE MOODS OR RAPID MOOD SWINGS
Rapid or extreme mood swings from elation to
depression.
Overreacting to a situation in an overly angry or
frightened manner
Speech patterns that lack the normal ups and
downs of emotion, or that contain uncontrollable
bursts of emotion
RECOGNIZING EDP’S
INNAPPROPRIATE MOODS OR RAPID MOOD SWINGS
Expressing feelings of persecutions (ex:
expressing ideas of being harassed or
threatened)
Obsessive thoughts or preoccupation with
subjects such as death or guilt
RECOGNIZING EDP’S
Acting or Threatening to Cause Injury to Self or
Others
Cutting self with a sharp object, causing
cigarette burns on body, starving self, or
expressing a desire to do the same to self or
others
RECOGNIZING EDP’S
Inappropriate Decorations
Strange trimmings or inappropriate use of
household items (ex: aluminum foil covering
windows)
RECOGNIZING EDP’S
Inappropriate Waste or Trash
Hoarding or accumulating extraordinary amounts
of household items (ex: accumulating
extraordinary amounts of string, newspapers,
paper bags, or trash to the extent that it
becomes a safety and health hazard)
The presence of feces or urine on the floors or
walls
PROPER TACTICS WHEN HANDLING EDP’S
Before arrival on scene of a possible EDP, or
substance abuse incident, think TACTICS.
PROPER TACTICS WHEN HANDLING EDP’S
Gather as much information as possible prior to arrival on
scene:
Whether the person is armed with weapons
Medical or psychiatric history
Location of subject (home, park, ect.)
Presence of other adults, children, friends
Whether the person is violent
PROPER TACTICS WHEN HANDLING EDP’S
Gather as much information as possible prior to arrival on
scene:
Whether the person has an arrest record or history of
violence
Whether the person has a history of alcohol or substance
abuse
Whether other uniformed personnel are on the scene
(ambulance, fire department, police)
Whether other officers know the person
PROPER TACTICS WHEN HANDLING EDP’S
Get as much information regarding the EDP as
possible from family members or other present.
This might include past incidents where police
have been called, hospitalizations, medications,
drug and alcohol use, past suicide attempts,
history of violence, availability of weapons, and/
or what triggered the current incident
PROPER TACTICS WHEN HANDLING EDP’S
One officer should assume the role of the
“Contact Officer”.
The contact officer will do all of the talking
with the EDP. (This prevents the confusion
and agitation that might ensue as a result of
too may people talking at the same time).
PROPER TACTICS WHEN HANDLING EDP’S
If you are the “contact partner”, lower you
radio.
The “cover officer” will handle the radio
Coordinate your plan of action
PROPER TACTICS WHEN HANDLING EDP’S
Be aware of you surroundings (look for
weapons, dangerous conditions, entrances,
exits, ect.)
Maintain a safe distance from the EDP. When an
EDP is violent, maintain a barrier between
yourself and the EDP.
PROPER TACTICS WHEN HANDLING EDP’S
Respect the EDP’s personal space (personal
space is defined as the amount of space an
individual needs between him and you to feel
safe)
Avoid attempts to intimidate or threaten EDP’s.
Such techniques may work with rational
criminals, but are likely to further excite
EDP’s.
PROPER TACTICS WHEN HANDLING EDP’S
Do not take offense at any actions or words directed
against you. Remember that you are there because
EDP’s have mental health problems.
Even those who may have committed crimes may not
be in control of themselves, and are not purposely
trying to offend you or anybody else.
Their actions are not deliberate choices. Instead, they
are the results of a psychiatric illness or other
condition.
PROPER TACTICS WHEN HANDLING EDP’S

Do not rush unless necessary to protect yourself or
others

Do not make sudden movements

Move deliberately and slowly

Keep a distance. DISTANCE EQUALS SAFETY

Keep a barrier between yourself and any potentially
dangerous EDP
PROPER TACTICS WHEN HANDLING EDP’S
Unless there is no other way to protect yourself or
others against imminent harm, avoid behavior
that causes agitation
Do not lie or try to deceive. Once you break trust
with an EDP, it is almost impossible to get it back
Do not try to intimidate or frighten the EDP into
submission
PROPER TACTICS WHEN HANDLING EDP’S



Do not “crowd” an EDP
Do not challenge the EDP’s perceptions.
These may be hallucinations or delusions, but
they are real to him
Do not stare at or maintain ongoing eye
contact with the EDP, who may see this as
challenging or threatening
PROPER TACTICS WHEN HANDLING EDP’S
Do not act in a confrontational manner by arguing
with or challenging the EDP
Remember, be empathetic and a good listener
If you are the designated “contact partner”, listen
and try to maintain empathy
Act as calmly as possible
PROPER TACTICS WHEN HANDLING EDP’S
Do not surprise your partner by taking any
sudden or unexpected action unless
someone’s safety is in imminent danger
Take as much time as you need to avoid injury
to anybody
Don’t lose this advantage by rushing or by
forcing a confrontation
Communicating with EDP’s
In order to assess the situation, you may want to
ask questions of the EDP.
When you try to communicate, be attentive to your
tone of voice and body language.
Listen carefully, be empathetic, and avoid phrases
that will trigger anger, misunderstandings, or
agitation.
Communicating with EDP’S
If there is something about you or your
partner’s way of talking that appears to
agitate the EDP, have the officer with the best
rapport be the designated contact officer
He or she will do all the talking with the EDP,
while the other officer acts as the cover
officer.
Communicating with EDP’s
Determine reasons for the individuals actions
Be honest- perceptions of deceit may escalate
violence and be perceived as a challenge
Listen to the person- be an active, empathetic
listener
Communicating with EDP’s
Ask simple and direct questions
Ask open-ended questions
Develop a rapport- this helps to overcome the
persons fear and mistrust
Communicating with EDP’s
Recognize and respond to physical needs
Paraphrase responses and check for
understanding
Identify and communicate with the healthy
aspects of the person
Communicating with EDP’s

Continually assess the situation for danger

Maintain adequate space between you and
the EDP

Be calm

Give firm, clear directions
Communicating with EDP’s
If possible only one officer should talk to the
person
Respond to apparent feelings, rather than
content
Respond to delusions and hallucinations by
talking about the person’s feelings rather
than what he is saying
Communicating with EDP’s
Be helpful. People, generally will respond to
questions concerning their basic needs (What
would make you feel safer? Calmer?
Address basic needs when appropriate (tissue,
cup of coffee, ect.)
Communicating with EDP’s
Use simple acknowledgements- this
encourages further communications:
Ex: “uh huh”, “I see”
Allow sufficient time for response
Communicating with EDP’s
Encourage the person to respond
Use calm, simple, direct instructional/ request
Restate person’s statements:
ex: EDP: “I can’t sleep”
Officer: “You’re having difficulty
sleeping?”
Communicating with EDP’s
Use the term “go on” and “and then…?” as
general leads
Give broad opening such as “you look like you
need to talk things over with someone”
This indicates willingness to listen and relieves
tension
Communicating with EDP’s
Seek clarification and problem for specifics.
This encourages talking and provides
accurate information
Ex: “I’m not sure I understand, could you
explain?”
Communicating with EDP’s
Avoid expressing approval or disapproval
Discuss alternatives. This enables the person to
consider options
Ex: “When you feel this depressed, what can
you think of that might make you feel better?”
Communicating with EDP’s
Use position of authority in a positive manner
Keep person talking; never reach complete
closure
Stress positives, such as person’s strengths,
qualities, and resources.
Communicating with EDP’s
Respect, attentiveness, openness, acceptance and
positive attitude increase effectiveness of
communication
Appeal to emotions rather than intellect if you
know the person is under the influence of drugs
Be quiet after asking a question; listen as carefully
as you question
Communicating with EDP’s- DO NOT
Not join into behavior related to the person’s
mental illness (agreeing, disagreeing with
delusions/ hallucinations)
Not stare at person- This may be interpreted as a
threat
Not confuse the person- One officer should
interact with the person. If a direction or
command is given, follow through
Communicating with EDP’s- DO NOT
Not give multiple choices- Giving multiple
choices increases the person’s confusion
Not whisper, joke or laugh- This increases the
person’s suspicions and the potential for
violence
Communicating with EDP’s- DO NOT
Not deceive the person- Being dishonest
increases fear and suspicion; the person will
likely discover the dishonesty and remember
it in any subsequent contacts
Don’t make promises/ threats that you can’t
follow through on
Communicating with EDP’s- DO NOT
Do not challenge the person’s delusions
Do not allow yourself to be manipulated
Avoid yes or no responses to personal
questions
Do not falsely threaten arrest
Communicating with EDP’s- DO NOT
Do not legalize
Do not overreact to gang language, sexual,
racial, ethnic insults
Do not order, command, warn, or threatenthis creates fear/ resistance, invites testing,
promotes rebellious behavior
Communicating with EDP’s- DO NOT
Do not moralize, preach, or judge- this
communicates a message of self righteousness.
Do not name-call or ridicule
Do not negate the seriousness of the crisis- this
causes misunderstanding, evokes hostility, and
causes the person to be embarrassed
POSITIONAL ASPHYXIA
Positional asphyxia is death by inability to
breath because of the position of ones body.
Occurs when subject is confined or held down
in probe positions, rear-cuffed, lying on their
abdomens.
HOW TO AVOID POSITIONAL ASPHYXIA
1.
2.
3.
Do not hogtie anybody
Get people in custody off their stomachs as
soon as possible
Do not use ropes on anybody
MHL LAWS
SEE HANDOUT
The five most frequent scenarios are as follows:
1.
A family member, friend, or other concerned person calls the police
for help during a psychiatric emergency.
2.
A person with mental illness feels suicidal and calls the police as a cry
for help.
3.
Police officers encounter a person with mental illness behaving
inappropriately in public.
4.
Citizens call the police because they feel threatened by the unusual
behavior or the mere presence of a person with mental illness.
5.
A person with mental illness calls the police for help because of
imagined threats.
BE SAFE