4013 Recognizing and responding to individuals in mental health crisis

Question 1

Mental illness is…

Answer 1

• A diagnosed/undiagnosed illness
• creating a problem in the areas of thoughts, emotional regulation, and/or behavior that reflects dysfunction

Question 2

______ 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.

Answer 2

Mental illness

Question 3

What situation is not considered a mental disorder?

Answer 3

A response to an extreme stressor, such as a loss, that is expected and culturally approved

Question 4

Stress created during a mental health crisis can often lead to abnormal behaviors in the mentally ill, often requiring _____.

Answer 4

Law enforcement assistance

Question 5

It should be noted that someone displaying a mental illness, abnormal behavior, or in crisis, does not mean….

Answer 5

They are involved in criminal activity

Question 6

What are 3 ways Generalized neurodevelopment disorder is characterized by?

Answer 6

• 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)

Question 7

Ranges in severity from a handicap that somewhat limits an
otherwise normal life to a devastating disability that may require institutional care.
(Lifelong condition)

Answer 7

Autism

Question 8

What may also be referred to “Elopement, Bolting, Fleeing, or Running?”
* Officers should know to ask “Has the child/adult ever run away before?”

Answer 8

Wandering - Autism

Question 9

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

Answer 9

Dementia

Question 10

What disease is an example of dementia?

Answer 10

Alzheimer’s is a type of dementia that affects memory, thinking and behavior Symptoms eventually grow severe enough to interfere with daily tasks

Question 11

How to interact with someone with dementia?

Answer 11

• Attempt to gain rapport
• Approach slowly
• Speak slowly
• Confrontation or correcting them about time or place may prove counter-productive and should be avoided

Question 12

What are 2 recognized trauma and stress-related disorders?

Answer 12

• Acute Stress Disorder (ASD), lasts less than a month
• Post Traumatic Stress Disorder (PTSD), lasts more than one month.

Question 13

Many _____, _____, _____, and _______ can cause behaviors that can be mistaken for mental illnesses.

Answer 13

Medicines, illegal drugs, alcohol, and cannabis

Question 14

When an officer suspects an overdose or is uncertain, it is necessary to do what?

Answer 14

Call emergency medical services immediately!

Question 15

Recognizing possible indicators of mental illness/abnormal behavior.
Behavioral cues can include:

Answer 15

• 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.

Question 16

_____ 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

Answer 16

Mental health crisis

Question 17

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.

Answer 17

Abnormal/Atypical behavior

Question 18

____ is what you are seeing from the individual when you arrive on scene and interact with the individual

Answer 18

Signs

Question 19

_____ are what they are telling you they are experiencing or feeling

Answer 19

Symptoms

Question 20

Trouble expressing oneself in speech. Maybe eager to communicate but has difficulty finding the right word. Grammar structure is below age level.

Answer 20

Expressive Language Disorder

Question 21

This is a disturbance in verbal fluency

Answer 21

Stuttering

Question 22

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.”

Answer 22

Phonological Disorder

Question 23

Disability that causes
impairment of understanding and language expression

Answer 23

Mixed Receptive-Expressive

Question 24

_____ occur when a person exhibits depression. bipolar disorder (Manic depression) or both in an alternating fashion

Answer 24

Mood disorders

Question 25

Officer response considerations for people with Bipolar disorder:

Answer 25

* 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!

Question 26

_____ is the act of intentionally causing one's own death.

Answer 26

Suicide

Question 27

Examples of life situations that can lead to suicide:

Answer 27

* 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

Question 28

Risk factors for suicide:

Answer 28

can include both the situations a person experience and how the person is feeling internally

Question 29

What are some suicide emotional and behavioral changes?

Answer 29

* 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.

Question 30

Warning signs of suicide:

Answer 30

* 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.

Question 31

Characteristics of suicide:

Answer 31

* Experiences drastic changes in behavior, loses interest in work, school, hobbies, etc. * Shows happiness after prolonged depression.

Question 32

______ 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.

Answer 32

Excited Delirium Syndrome

Question 33

Characteristics of Excitied Delirium Syndrome:

Answer 33

severe agitation, unusual strength, tolerance to significant pain and elevated body temperature.

Question 34

Many “in custody deaths” are linked to _____

Answer 34

Excited delirium syndrome

Question 35

Some cases of severe _____, ______, or ______ can result in excited delirium syndrome

Answer 35

Intoxication, drug abuse, or substance use disorder

Question 36

Scene Assessment: plan of approach

Answer 36

* 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)

Question 37

If the person is a danger to himself/herself or another person the officer should….

Answer 37

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.

Question 38

Rapport building is critical in most situations dealing with a person in ____

Answer 38

Mental health crisis

Question 39

Contact with the subject: The goal is ______ but be prepared for noncompliance

Answer 39

Voluntary compliance

Question 40

Avoid arguing with the person if…. - the person is hallucinating - the person is delusional * Do NOT get caught up in their perception of reality *

Question 41

Recognize possible indicators of mental illness/abnormal behavior. Verbal cues may include:

Answer 41

* 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

Question 42

What are 2 things to do once the scene and subject(s) are secured?

Answer 42

1. Preserve evidence 2. Interview witnesses

Question 43

The officer MUST be able to articulate why the person's behaviors are a ______

Answer 43

Danger to themselves or others

Question 44

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.

Answer 44

Burnout

Question 45

Managing the scene. Taking into Custody:

Answer 45

- Your (Officer) safety - Safety of others - Individual(s) safety - In-custody deaths (considerations)

Question 46

What is Deinstitutionalization?

Answer 46

* 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.

Question 47

Disposition of the individual is critical. Assistance considerations for the individual in crisis include:

Answer 47

* 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