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Training for law enforcement and first responders to see
perspectives through the eyes of people with mental illness
Mental Illness Prevalence in America
Mental Health of Inmates
Mental Health Disorders & Symptoms
Interactions with Individuals in Crisis
Professionals’ Perspective/Counter-Transference
Self-Care
 324 million Americans-2016
 43.8 million (18.5%) living with mental
illness
 1 in 5 adults
 1.1% are diagnosed with Schizophrenia
 2.6 % are diagnosed with Bipolar
disorder
 6.9 % major depressive episode in the
past year
 18.1% of adults experienced anxiety
disorders
 20.2 million adults in the U.S. who
experienced a substance use disorder
 50.5% had a co-occurring mental illness
 People with mental illness account
for almost 25% of police involved
deaths
 In 2015-
 991 PEOPLE WERE SHOT AND
KILLED BY LAW ENFORCEMENT
 251 WERE KNOWN TO BE
MENTALLY ILL
 -Washington Post
 Almost 25% of both State prisoners
and jail inmates who had a mental
health problem have served 3 or
more prior incarcerations
 State prisons reporting mental
health problems:
 73% of females and 55% of males
 Federal prisons:
 61% of females and 44% of males
 local jails: 75% of females and 63% of
males
 70% of youth in juvenile justice
systems have at least one mental
health condition and at least 20%
live with a serious mental illness
 Hallucinations
 See people or objects, hear voices,
noises that others do not see or hear
 Delusions
 religious preoccupation, paranoia
 Onset late teens, early 20s
 Combination of bipolar and
schizophrenia symptoms
 Highs (mania) and Lows (depression)
 Delusions
 Hallucinations
 Rumination of guilt/worthlessness
 Persistent, prolonged contemplation
of death, loss or suicide
 Hallucinations/Delusions
 Increased energy when a suicidal
plan and intention is created
 “Nothing to lose”
 Staying awake for days at a time
(mania)
 Inflated sense of self/entitlement
 Impulsive spending/gambling
 Risk-taking behavior
 driving, sexual activity, substance abuse
 Sudden impatience/irritability
Do:
 Voice Tone
 Express Empathy
 Actively Listen-
 Hear their Story
 What Brought Them to this Point?
 Talk Adult-to-Adult
 Consider Sensitive Topics
 Cultural Influences, Sexual Orientation,
etc.
 Use “Person-First” Language
 "I" Statements
 Reflection
 Summary
Don’t:
 Be Confrontational
 Laugh about Unusual Behavior
 Argue with Unusual Beliefs or
Paranoia
 Return Negative Behavior
 Rude, impatient, disrespectful
 Take Things Personally
 One’s behavior is a reflection of their
own perspective not a point to argue
 Shame, Blame or Stigmatize
 How is this person impacting you?
 Self- Awareness
 Facial Expressions, Stance, Tone
 Recognizing Triggers
 Person reminds you of your mother-in-
law
 What are your own stereotypes?
“WHAT HAVE YOU DONE FOR
YOU LATELY?”
Therapy
Hobbies
Goals
Andreasen, Nancy. (2001). Brave New Brain: Conquering Mental Illness in the Era of the Genome. New York, NY: Oxford University Press.
Asami T, Whitford TJ, Bouix S, Dickey CC, Niznikiewicz M, Shenton,… & McCarley RW. (2013). Globally and locally reduced MRI gray matter volumes in neuroleptic-naïve men with
schizotypal personality disorder: Association with negative symptoms. Journal of the American Medical Association,70.4, 361-372.
Bellani, M., Dusi, N., Yeh, P.H., Soares, J.C., & Brambilla, P. (2011).The effects of antidepressants on human brain as detected by imaging studies. Focus on major depression. Progress in
Neuro- Psychopharmacology and Biological Psychiatry, 35.7, 1544-1552.
Birmaher, B., Axelson, D., Strober, M., Gill, M.K., Valeri, S., Chiappetta, L, … & Keller, M. (2006). Clinical course of children and adolescents with bipolar spectrum disorders. Archives of
General Psychiatry, 63.2, 175-83.
Fornito, A., Yoon, J., Zalesky, A., Bullmore, E.T., & Carter, C.S. (2011). General and specific functional connectivity disturbances in first-episode schizophrenia during cognitive control
performance. Biological Psychiatry, 70.1, 64-72.
Fujii, D.E., & Wylie, A.M. (2003). Neurocognition and community outcome in schizophrenia: Long- term predictive validity. Schizophrenia Research, 59.2, 219-223.
Li, H., Chan, R.C., McAlonan, G.M., & Gong, Q.Y. (2009). Facial emotion processing in schizophrenia: A meta-analysis of functional neuroimaging data. Schizophrenia Bulletin, 36.5, 1029-
1039.
Milev, P., Ho, B., Arndt, S., & Andreasen, N. (2005). Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: A longitudinal first-episode study
with 7-year follow-up. American Journal of Psychiatry, 162.3, 495-506.
Nuechterlein, K.H., Subotnik, K.L., Green, M.F, Ventura, J., Asarnow, R.F., Gitlin, M.J., … & Mintz, J. (2011). Neurocognitive predictors of work outcome in recent-onset schizophrenia.
Schizophrenia Bulletin, 37 (2), S33-S40.
Ortiz-Gil, J., Pomarol-Clotet, E., Salvador, R., Canales-Rodríguez, E.J., Sarró, S., Gomar, J.J.,… & McKenna, P.J. (2011) Neural correlates of cognitive impairment in schizophrenia. British
Journal of Psychiatry, 199.3, 202-210.
Perez-Costas, E., Melendez-Ferro, M., & Roberts, R.C. (2010). Basal ganglia pathology in schizophrenia: Dopamine connections and anomalies. Journal of Neurochemistry, 113.2 287-302.
Savitz, J., & Drevets, W.C. (2009). Bipolar and major depressive disorder: Neuroimaging the developmental-degenerative divide. Neuroscience and Biobehavioral Reviews, 33.5, 699-771.
Stahl, S. (2000). Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (2nd ed.). Cambridge, UK: Cambridge University Press.
Ventura, J., Subotnik, K.L., Guzik, L.H., Hellemann, G.S., Gitlin, M.J., Wood, R.C., & Nuechterlein, K.H. (2011). Remission and recovery during the first outpatient year of the early course of
schizophrenia. Schizophrenia Research, 132.1, 18-23

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Communicating with Someone Who is Experiencing a Mental Health Crisis

  • 1. Training for law enforcement and first responders to see perspectives through the eyes of people with mental illness
  • 2. Mental Illness Prevalence in America Mental Health of Inmates Mental Health Disorders & Symptoms Interactions with Individuals in Crisis Professionals’ Perspective/Counter-Transference Self-Care
  • 3.  324 million Americans-2016  43.8 million (18.5%) living with mental illness  1 in 5 adults  1.1% are diagnosed with Schizophrenia  2.6 % are diagnosed with Bipolar disorder  6.9 % major depressive episode in the past year  18.1% of adults experienced anxiety disorders  20.2 million adults in the U.S. who experienced a substance use disorder  50.5% had a co-occurring mental illness  People with mental illness account for almost 25% of police involved deaths  In 2015-  991 PEOPLE WERE SHOT AND KILLED BY LAW ENFORCEMENT  251 WERE KNOWN TO BE MENTALLY ILL  -Washington Post
  • 4.  Almost 25% of both State prisoners and jail inmates who had a mental health problem have served 3 or more prior incarcerations  State prisons reporting mental health problems:  73% of females and 55% of males  Federal prisons:  61% of females and 44% of males  local jails: 75% of females and 63% of males  70% of youth in juvenile justice systems have at least one mental health condition and at least 20% live with a serious mental illness
  • 5.  Hallucinations  See people or objects, hear voices, noises that others do not see or hear  Delusions  religious preoccupation, paranoia  Onset late teens, early 20s  Combination of bipolar and schizophrenia symptoms  Highs (mania) and Lows (depression)  Delusions  Hallucinations
  • 6.  Rumination of guilt/worthlessness  Persistent, prolonged contemplation of death, loss or suicide  Hallucinations/Delusions  Increased energy when a suicidal plan and intention is created  “Nothing to lose”  Staying awake for days at a time (mania)  Inflated sense of self/entitlement  Impulsive spending/gambling  Risk-taking behavior  driving, sexual activity, substance abuse  Sudden impatience/irritability
  • 7. Do:  Voice Tone  Express Empathy  Actively Listen-  Hear their Story  What Brought Them to this Point?  Talk Adult-to-Adult  Consider Sensitive Topics  Cultural Influences, Sexual Orientation, etc.  Use “Person-First” Language  "I" Statements  Reflection  Summary Don’t:  Be Confrontational  Laugh about Unusual Behavior  Argue with Unusual Beliefs or Paranoia  Return Negative Behavior  Rude, impatient, disrespectful  Take Things Personally  One’s behavior is a reflection of their own perspective not a point to argue  Shame, Blame or Stigmatize
  • 8.  How is this person impacting you?  Self- Awareness  Facial Expressions, Stance, Tone  Recognizing Triggers  Person reminds you of your mother-in- law  What are your own stereotypes?
  • 9. “WHAT HAVE YOU DONE FOR YOU LATELY?” Therapy Hobbies Goals
  • 10. Andreasen, Nancy. (2001). Brave New Brain: Conquering Mental Illness in the Era of the Genome. New York, NY: Oxford University Press. Asami T, Whitford TJ, Bouix S, Dickey CC, Niznikiewicz M, Shenton,… & McCarley RW. (2013). Globally and locally reduced MRI gray matter volumes in neuroleptic-naïve men with schizotypal personality disorder: Association with negative symptoms. Journal of the American Medical Association,70.4, 361-372. Bellani, M., Dusi, N., Yeh, P.H., Soares, J.C., & Brambilla, P. (2011).The effects of antidepressants on human brain as detected by imaging studies. Focus on major depression. Progress in Neuro- Psychopharmacology and Biological Psychiatry, 35.7, 1544-1552. Birmaher, B., Axelson, D., Strober, M., Gill, M.K., Valeri, S., Chiappetta, L, … & Keller, M. (2006). Clinical course of children and adolescents with bipolar spectrum disorders. Archives of General Psychiatry, 63.2, 175-83. Fornito, A., Yoon, J., Zalesky, A., Bullmore, E.T., & Carter, C.S. (2011). General and specific functional connectivity disturbances in first-episode schizophrenia during cognitive control performance. Biological Psychiatry, 70.1, 64-72. Fujii, D.E., & Wylie, A.M. (2003). Neurocognition and community outcome in schizophrenia: Long- term predictive validity. Schizophrenia Research, 59.2, 219-223. Li, H., Chan, R.C., McAlonan, G.M., & Gong, Q.Y. (2009). Facial emotion processing in schizophrenia: A meta-analysis of functional neuroimaging data. Schizophrenia Bulletin, 36.5, 1029- 1039. Milev, P., Ho, B., Arndt, S., & Andreasen, N. (2005). Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: A longitudinal first-episode study with 7-year follow-up. American Journal of Psychiatry, 162.3, 495-506. Nuechterlein, K.H., Subotnik, K.L., Green, M.F, Ventura, J., Asarnow, R.F., Gitlin, M.J., … & Mintz, J. (2011). Neurocognitive predictors of work outcome in recent-onset schizophrenia. Schizophrenia Bulletin, 37 (2), S33-S40. Ortiz-Gil, J., Pomarol-Clotet, E., Salvador, R., Canales-Rodríguez, E.J., Sarró, S., Gomar, J.J.,… & McKenna, P.J. (2011) Neural correlates of cognitive impairment in schizophrenia. British Journal of Psychiatry, 199.3, 202-210. Perez-Costas, E., Melendez-Ferro, M., & Roberts, R.C. (2010). Basal ganglia pathology in schizophrenia: Dopamine connections and anomalies. Journal of Neurochemistry, 113.2 287-302. Savitz, J., & Drevets, W.C. (2009). Bipolar and major depressive disorder: Neuroimaging the developmental-degenerative divide. Neuroscience and Biobehavioral Reviews, 33.5, 699-771. Stahl, S. (2000). Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (2nd ed.). Cambridge, UK: Cambridge University Press. Ventura, J., Subotnik, K.L., Guzik, L.H., Hellemann, G.S., Gitlin, M.J., Wood, R.C., & Nuechterlein, K.H. (2011). Remission and recovery during the first outpatient year of the early course of schizophrenia. Schizophrenia Research, 132.1, 18-23