police response to edp’s

POLICE RESPONSE TO EDPS

POLICE RESPONSE TO EDPSBrad Natalizio

Village of Chester

1REALITY FOR VILLAGE OF CHESTER P.D.

15 High Street: House emotionally disturbed persons

69 Brookside Avenue: Life Choices, mental retardation, schizophrenia

3 Maple Avenue: Chester Learning Center. Students must be emotionally disturbed to qualify to get into program. Ranges from ADD, ADHD, Bi-Polar, child-hood schizophrenia

Meadow Avenue: Mental retardation

POLICE RESPONSE TO EDPSHistory

Police encounters with mentally ill persons first became a major issue in the late 1960s, when a deinstitutionalization movement began.

This was a long legal battle that was designed to protect people who, were believed to be mentally ill.POLICE RESPONSE TO EDPS3History

Prior to the 1960s the mentally ill were virtually warehoused in large state psychiatric hospitals in abject living conditions.

Little emphasis placed on their treatment. POLICE RESPONSE TO EDPS4History

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. POLICE RESPONSE TO EDPS5History

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 EDPs.POLICE RESPONSE TO EDPS6History

Most police departments in the early 1980s made attempts to incorporate specialized approaches and specific training in how to deal more effectively with the mentally ill.

POLICE RESPONSE TO EDPS7WHY IS IT IMPORTANT FOR POLICE OFFICERS TO KNOW ABOUT EDPS?

Encounters with EDPs 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 EDPs to act in ways that require officers to use force that might otherwise have been avoided.

POLICE RESPONES TO EDPS8WHY IS IT IMPORTANT FOR POLICE OFFICERS TO KNOW ABOUT EDPS?

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.

POLICE RESPONSE TO EDPS9WHY IS IT IMPORTANT FOR POLICE OFFICERS TO KNOW ABOUT EDPS?

Police response to EDP situations requires specialized skills and training.

Knowing how to communicate verbally and non-verbally, and knowing how to intervene tactfully and sensitively can dramatically enhance the likelihood that situations involving the EDP will be resolved safely and effectively. POLICE RESPONSE TO EDPS10WHY IS IT IMPORTANT FOR POLICE OFFICERS TO KNOW ABOUT EDPS?

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 EDPSs.Lives and safety of other innocent people.Lives and safety of US. POLICE RESPONSE TO EDPS11

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.POLICE RESPONSE TO EDPS13Stats

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. POLICE RESPONSE TO EDPS14Stats

Most people diagnosed with mental illness have never been hospitalized and do not need in-patient 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. POLICE RESPONSE TO EDPS15Stats

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. POLICE RESPONSE TO EDPS16ABNORMAL PSYCHOLOGY

Anxiety DisordersStress DisordersSomatoform and Dissociative DisordersMood DisordersSchizophreniaPersonality DisordersPOLICE RESPONSE TO EDPS17Anxiety 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


18ANXIETY 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.


19Anxiety 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. POLICE RESPONSE TO EDPS

20Anxiety 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.

POLICE RESPONSE TO EDPS21STRESS 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

POLICE RESPONSE TO EDPS22Stress 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. POLICE RESONSE TO EDPS23Anxiety 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

POLICE RESPONSE TO EDPS24Somatoform 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.

POLICE RESPONSE TO EDPS25Somatoform 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.POLICE RESPONSE TO EDPS26MOOD DISORDERS

Unipolar Depression

Bipolar DisorderPOLICE RESPONSE TO EDPS27MOOD 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.

POLICE RESPONSE TO EDPS28Symptoms of Depression:

Feeling of emptinessLose their sense of humorCrying spellsMay have to force themselves to work, talk with friendsLack of drive, initiative, spontaneity May experience anxiety, anger, agitation Loss of desire to pursue their usual activitiesMay speak slowerLess productiveLack of energyNegative views of themselves POLICE RESPONSE TO EDPS29MOOD 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. POLICE RESPONSE TO EDPS30MOOD DISORDERS

Bipolar Disorder: A disorder marked by altering or intermixed periods of mania and depression.

Emotional rollercoaster which shifts back and forth between moods. POLICE RESPONSE TO EDPS31MOOD 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. POLICE RESPONSE TO EDPS32SUICIDE

A self inflicted death in which the person acts intentionally, directly, and consciously.

POLICE RESPONSE TO EDPS33WHAT TRIGGERS SUICIDE?

Suicidal acts may be connected to recent events or current conditions in a persons life.

Common triggering factors include stressful events, mood and thought changes, alcohol and other drug use, and mental disorders.

POLICE RESPONSE TO EDPS34Approaching 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. POLICE RESPONSE TO EDPS35Approaching 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. POLICE RESPONSE TO EDPS36Approaching 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.POLICE RESPONSE TO EDPS37Approaching 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. POLICE RESPONSE TO EDPS38Approaching 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.POLICE RESPONSE TO EDPS39Approaching Suicidal People

Do not make sudden moves- use physical tactics as a last resort.

Do not leave person unattended.

Do not deny the persons suicidal feelings.

Do not rush/ pressure the person to make decisions or to abandon their suicidal plan. POLICE RESPONSE TO EDPS40SCHIZOPHRENIA

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.

POLICE RESPONSE TO EDPS41Schizophrenia

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 outPOLICE RESPONSE TO EDPS42Schizophrenia

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

POLICE RESPONSE TO EDPS43Schizophrenia

Paranoid thinking

Irrational belief that he is superior; has a special calling; is God

Hostility and belligerence

Repetitive movementsPOLICE RESPONSE TO EDPS

44Schizophrenia

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 thoughtsPOLICE RESPONSE TO EDPS45Schizophrenia

Dramatically increased or decreased body movements (characteristic of what is called catatonic schizophrenia)

Impaired impulse controlPOLICE RESPONSE TO EDPS

46Schizophrenia

Medications that are used to treat individuals who are psychotic and/ or delusional include:

HaldolProlixinStellazineClozarilRisperdalZyprexaGeodanAbilifyPOLICE RESPONSE TO EDPS47PERSONALITY DISORDERS

A very rigid pattern of inner experience and outward behavior that differs from the expectations of ones 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.POLICE RESPONSE TO EDPS48PERSONALITY DISORDERS

Personality disorders are separated into 3 groups: Odd or eccentric behaviorDramatic behaviorHigh degree of anxietyPOLICE RESPONSE TO EDPS49

RECOGNIZING EDPS

Recognizing and properly handling EDPs is critical to the effectiveness of Police Officers.

EDPs often exhibit behavior patterns and verbal indicators that seem Inappropriate, Inflexible, and Impulsive. POLICE RESPONSE TO EDPS51RECOGNIZING EDPS

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)POLICE RESPONSE TO EDPS

52RECOGNIZING EDPS

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)


53RECOGNIZING EDPS

Disturbances in Perception

Responding to voices or objects that are not there

Expressions of extravagant ideas (ex: the person believes they are Dan Marino)

POLICE RESPONSE TO EDPS54RECOGNIZING EDPS

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.


DISTURBANCES IN THOUGHT

It may be hard to follow an EDPs 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. POLICE RESPONSE TO EDPS56RECOGNIZING EDPS

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 emotionPOLICE RESPONSE TO EDPS57RECOGNIZING EDPS

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


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 othersPOLICE RESPONSE TO EDPS59RECOGNIZING EDPS

Inappropriate Decorations

Strange trimmings or inappropriate use of household items (ex: aluminum foil covering windows)


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 POLICE RESPONSE TO EDPS61PROPER TACTICS WHEN HANDLING EDPS

Before arrival on scene of a possible EDP, or substance abuse incident, think TACTICS.


62PROPER TACTICS WHEN HANDLING EDPS

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



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



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

POLICE RESPONSE TO EDPS65PROPER TACTICS WHEN HANDLING EDPS

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).



If you are the contact partner, lower you radio.

The cover officer will handle the radio

Coordinate your plan of action

POLICE RESPONSE TO EPDS67PROPER TACTICS WHEN HANDLING EDPS

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.POLICE RESPONSE TO EDPS68PROPER TACTICS WHEN HANDLING EDPS

Respect the EDPs 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 EDPs. Such techniques may work with rational criminals, but are likely to further excite EDPs. POLICE RESPONSE TO EDPS69PROPER TACTICS WHEN HANDLING EDPS

Do not take offense at any actions or words directed against you. Remember that you are there because EDPs 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. POLICE RESPONSE TO EDPS70PROPER TACTICS WHEN HANDLING EDPS

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

POLICE RESPONSE TO EDPS71

PROPER TACTICS WHEN HANDLING EDPS

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 submissionPOLICE RESPONSE TO EDPS


Do not crowd an EDP

Do not challenge the EDPs 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

POLICE RESPONSE TO EDPS74PROPER TACTICS WHEN HANDLING EDPS

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 possiblePOLICE RESPONSE TO EDPS75PROPER TACTICS WHEN HANDLING EDPS

Do not surprise your partner by taking any sudden or unexpected action unless someones safety is in imminent danger

Take as much time as you need to avoid injury to anybody

Dont lose this advantage by rushing or by forcing a confrontation

POLICE RESPONSE TO EDPS76Communicating with EDPs

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. POLICE RESPONSE TO EDPS77Communicating with EDPS

If there is something about you or your partners 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. POLICE RESPONSE TO EDPS78Communicating with EDPs

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 POLICE RESPONSE TO EDPS79Communicating with EDPs

Ask simple and direct questions

Ask open-ended questions

Develop a rapport- this helps to overcome the persons fear and mistrust


Recognize and respond to physical needs

Paraphrase responses and check for understanding

Identify and communicate with the healthy aspects of the person


Continually assess the situation for danger

Maintain adequate space between you and the EDP

Be calm

Give firm, clear directionsPOLICE RESPONSE TO EDPS82Communicating with EDPs

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 persons feelings rather than what he is sayingPOLICE RESPONSE TO EDPS83Communicating with EDPs

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.)


84Communicating with EDPs

Use simple acknowledgements- this encourages further communications:

Ex: uh huh, I see

Allow sufficient time for responsePOLICE RESPONSE TO EDPS85Communicating with EDPs

Encourage the person to respond

Use calm, simple, direct instructional/ request

Restate persons statements:ex: EDP: I cant sleepOfficer: Youre having difficulty sleeping?POLICE RESPONSE TO EDPS86Communicating with EDPs

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 tensionPOLICE RESPONSE TO EDPS87Communicating with EDPs

Seek clarification and problem for specifics. This encourages talking and provides accurate information

Ex: Im not sure I understand, could you explain?POLICE RESPONSE TO EDPS88Communicating with EDPs

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?POLICE RESPONSE TO EDPS89Communicating with EDPs

Use position of authority in a positive manner

Keep person talking; never reach complete closure

Stress positives, such as persons strengths, qualities, and resources.POLICE RESPONSE TO EDPS90Communicating with EDPs

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 questionPOLICE RESPONSE TO EDPS91

Communicating with EDPs- DO NOT

Not join into behavior related to the persons 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 throughPOLICE RESPONSE TO EDPS

93Communicating with EDPs- DO NOT

Not give multiple choices- Giving multiple choices increases the persons confusion

Not whisper, joke or laugh- This increases the persons suspicions and the potential for violencePOLICE RESPONSE TO EDPS94Communicating with EDPs- 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

Dont make promises/ threats that you cant follow through onPOLICE RESPONSE TO EDPS95Communicating with EDPs- DO NOT

Do not challenge the persons delusions

Do not allow yourself to be manipulated

Avoid yes or no responses to personal questions

Do not falsely threaten arrestPOLICE RESPONSE TO EDPS

96Communicating with EDPs- DO NOT

Do not legalize

Do not overreact to gang language, sexual, racial, ethnic insults

Do not order, command, warn, or threaten- this creates fear/ resistance, invites testing, promotes rebellious behavior

POLICE RESPONSE TO EDPS97Communicating with EDPs- 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

POLICE RESPONSE TO EDPS98POSITIONAL 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.

POLICE RESPONSE TO EDPS99HOW TO AVOID POSITIONAL ASPHYXIA

Do not hogtie anybodyGet people in custody off their stomachs as soon as possibleDo not use ropes on anybodyPOLICE RESPONSE TO EDPS100MHL LAWS

SEE HANDOUTPOLICE RESPONSE TO EDPS101The five most frequent scenarios are as follows:

A family member, friend, or other concerned person calls the police for help during a psychiatric emergency.

A person with mental illness feels suicidal and calls the police as a cry for help.

Police officers encounter a person with mental illness behaving inappropriately in public.

Citizens call the police because they feel threatened by the unusual behavior or the mere presence of a person with mental illness.

A person with mental illness calls the police for help because of imagined threats.

POLICE RESPONSE TO EDPS102BE SAFEPOLICE RESPONSE TO EDPS103

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