© 2016 Laureate Education, Inc. Page 1 of 1 Emergency Department HCAPHS Data Emergency Department State Average National Average Average time patients who came to the ED with broken bones had to wait to before getting medication 47 minutes 46 minutes 54 minutes Average (median) time patients spent in the ED before they were admitted to the hospital as an inpatient 246 minutes 218 minutes 200 minutes Average (median) time patient spent in the ED after the doctor decided to admit them as an inpatient before leaving the ED for their inpatient room 65 minutes 60 minutes 48 minutes Average time patients spend in the ED before leaving from the visit 140 minutes 116 minutes 116 minutes Average time spent in the ED before they were seen by a health care professional 15 minutes 18 minutes 21 minutes Listen to Me First Week 3 Transcript Version 1 3Listen to Me First: Week 3 Transcript Speakers: Host, Dr. Grace Telesco Host: Welcome to this week’s podcast. This week we’ll be discussing mental health and addictions. What characteristics do persons with mental health issues or disorders display? DR. TELESCO: Well, in order to really answer that question, we want to look at what is positive mental health, right? So we want to say a person who has positive and healthy mental health, if you will, is going to be somebody who is stable, who has self-confidence. Not to say that we don’t have our neurosis, because we all do—you know, anxiety and stuff like that. But in extremes, it may not be good. So how do we deal on a day-to-day basis with our normal life on life’s terms? How do we deal with it? Usually, you know, we go about our day. We’re pretty stable. We have some normal alterations in our thinking or our mood. We’re not very, very sad all of the time. We’re not very, very happy all of the time. So these are the extremes where it starts to become possibly a disorder or an unhealthy mental health situation. So characteristics of mental illness really zero in on our thinking, our mood, and how we act—our behavior. And some of these things are disruptions in our daily function, anxiety or personality disorders where there might be delusions. There might be voices I am hearing or things I am seeing that aren’t real. So it goes from this almost a continuum of mental health: all the way from very good mental health to very, very dangerous, unhealthy mental health situations. Host: How does addiction and substance abuse relate to mental health issues? DR. TELESCO: You know, let’s not forget that this course is about: criminal justice overall. So it’s not necessarily just law enforcement. Law enforcement are your first-line service providers. They are going to be the ones who are going to see a lot of people who are suffering from mental illness and addiction. But that is not to say that court officers, corrections officers, even judges and prosecutors and defense attorneys aren’t going to be.

1. © 2016 Laureate Education, Inc. Page 1 of 1
Emergency Department HCAPHS Data
Emergency
Department
State
Average
National
Average
Average time patients who came to the ED
with broken bones had to wait to before
getting medication
47 minutes 46 minutes 54 minutes
Average (median) time patients spent in the
ED before they were admitted to the hospital
as an inpatient
246 minutes 218 minutes 200 minutes
Average (median) time patient spent in the
ED after the doctor decided to admit them
as an inpatient before leaving the ED for
their inpatient room

2. 65 minutes 60 minutes 48 minutes
Average time patients spend in the ED
before leaving from the visit
140 minutes 116 minutes 116 minutes
Average time spent in the ED before they
were seen by a health care professional
15 minutes 18 minutes 21 minutes
Listen to Me First Week 3 Transcript
Version 1
3Listen to Me First: Week 3 Transcript
Speakers: Host, Dr. Grace Telesco
Host: Welcome to this week’s podcast. This week we’ll be
discussing mental health and addictions. What characteristics do
persons with mental health issues or disorders display?
DR. TELESCO: Well, in order to really answer that question,
we want to look at what is positive mental health, right? So we
want to say a person who has positive and healthy mental
health, if you will, is going to be somebody who is stable, who
has self-confidence. Not to say that we don’t have our neurosis,
because we all do—you know, anxiety and stuff like that. But in
extremes, it may not be good. So how do we deal on a day-to-
day basis with our normal life on life’s terms? How do we deal

3. with it?
Usually, you know, we go about our day. We’re pretty stable.
We have some normal alterations in our thinking or our mood.
We’re not very, very sad all of the time. We’re not very, very
happy all of the time. So these are the extremes where it starts
to become possibly a disorder or an unhealthy mental health
situation.
So characteristics of mental illness really zero in on our
thinking, our mood, and how we act—our behavior. And some
of these things are disruptions in our daily function, anxiety or
personality disorders where there might be delusions. There
might be voices I am hearing or things I am seeing that aren’t
real.
So it goes from this almost a continuum of mental health: all the
way from very good mental health to very, very dangerous,
unhealthy mental health situations.
Host: How does addiction and substance abuse relate to mental
health issues?
DR. TELESCO: You know, let’s not forget that this course is
about: criminal justice overall. So it’s not necessarily just law
enforcement. Law enforcement are your first-line service
providers. They are going to be the ones who are going to see a
lot of people who are suffering from mental illness and
addiction. But that is not to say that court officers, corrections
officers, even judges and prosecutors and defense attorneys
aren’t going to be involved and interfacing with people who are
mentally ill, because that is true. They do.
So when you talk about the training, it depends. As a law
enforcement officer, I am going to have a component of the
curriculum that is going to be dedicated specifically to how we

4. handle mental illness. How do we recognize what mental illness
is, and how do we effectively take this person who is sick,
actually, not a criminal, although they may have committed a
crime, but they are not necessarily going to be adjudicated in a
criminal court. They might be adjudicated through – in a
psychiatric emergency room and then ultimately maybe a
psychiatric hospital or state facility of some. We know that
there are prisons with specific sections that are dedicated
specifically to people who are the criminally insane.
So in answer to your question about the training, officers –
police officers, court officers, and correctional officers go
through a vast amount of training about mental illness, what it
is and how to recognize it, and addiction, what addiction is and
its characteristics. But let’s not misunderstand and think that
because you have graduated from the police academy, now you
are a psychiatrist. You’re not.
So we deal sort of with apparent mental illness. What is it
appearing to be based on one’s behavior?
Host: So what is the relationship between addiction and crime?
DR. TELESCO: Well first of all, in the DSM IV, which is the
Diagnostic and Statistical Manual of Mental Disorders (the big
bible so to speak for psychiatry and psychology), addiction and
substance abuse are included as mental disorders. So people
who are addicted to a substance, whether it be cocaine, heroin
or opiates, alcohol, all of these different kinds of dependency
issues are in the DSM IV. So it is a mental illness actually. So
mental illness and mental health is the big umbrella, and
substance abuse and addiction come underneath that umbrella.
Now, what is addiction? Addiction manifests itself in many
different ways, but it is usually a physical and an
emotional/psychological dependence on a particular chemical

5. substance. It is a disease model. So what does that mean?
That means that it is progressive, it is fatal it if goes untreated.
Now, how does all of this come to make itself known within
criminal justice? About seventy percent of people who are
incarcerated and a large, large majority of people who find
themselves in the criminal justice system are there because of
some type of drug. It is some type of drug-related crime. So that
means that we’re sort of punishing, incarcerating people
because of something that is a mental illness. It falls under a
mental disorder and so that is not a judgment call. That is just a
fact. That is just making an observation that police officers are
undoubtedly going to be involved in some way, shape, or form
with people who are suffering from the disease of addiction,
like illegal possession, sale, trafficking, prostitution, DWI,
whatever it might be.
And the same goes for correction officers who are going to be
interfacing with offenders, inmates, who are incarcerated
because of their drug dependency or their drug use, and the
same thing with courts. And so this week we talk a lot about
drug courts and some of the effectiveness that we see with drug
court strategies and how they are helping people. Not as much
as we would like, because we see that the recidivism rate is still
high, but nevertheless, drug courts seem to be an effective
alternative program for people who suffer from the disease of
addiction.
HOST
What is the criminal justice professional’s role in providing
intervention and rehabilitation to substance-abuse offenders and
persons with mental illness?
DR. TELESCO: So there’s two things. Let’s talk about
substance abuse first, and as we said earlier, about the
relationship between addiction and crime that we see manifest

6. in DWI, for example, or possession. Possession is easy.
Everybody gets that, possession of controlled substances. But,
you know, what about a burglary? How is a burglary related to
addiction?
Well, many times people who are suffering from the disease of
addiction will go to any lengths to feed that addiction, and that
might mean committing crimes like burglaries. So what happens
then in terms of the role of criminal justice and criminal justice
professionals in helping these people? Because really – it’s easy
for us to just put them in jail and incarcerate them, but how are
we helping them in terms of helping them change their
behavior?
One way with substance abuse has been through drug court.
Drug court programs have really helped. As part of the
condition for probation or condition for parole, or the condition
for whatever the sentence is, this individual must attend twelve-
step meetings or twelve-step groups, and so they have to get
their sheet signed and stuff like that, and it is kind of forcing
them into trying to get help for themselves and rehabilitate
themselves. And we have found that is has been effective. Not
only anecdotally, but also there is some empirical evidence to
suggest that the drug court as a strategy is very helpful.
So the role of the criminal justice professional, the judge, for
example, who is in charge of drug court. That judge is playing
the role not only of serving justice and seeing that justice is
served but also to try to rehabilitate and to try to intervene in
these addicts’ lives.
So that is one way in terms of substance abuse. As far as mental
health and mental illness, you know, we don’t want to
criminalize people who are mentally ill. And the National
Association of People with Mental Illness, NAMI, and the other
organization that is Families of People who Suffer with Mental

7. Illness, many times, they are advocating for criminal justice
professionals to not criminalize these people who are suffering
from mental illness. They are not criminals; they are people
who need help.
And so some of the strategies, as well as the role that criminal
justice professionals play, is to try to really intervene
effectively in this person’s life. One of those examples is what
are called crisis intervention teams, CITs. Memphis has it, for
example, and some of the police departments that have the
resources and are a little smaller are able to implement these
strategies.
But what a CIT program is, it consists of a psychiatric nurse. It
consists of a social workers and a police officer who will
respond to the scene whenever there is someone who is
apparently mentally ill and might be a danger to themselves or
others. So there is a kind of on-the-scene, on-site assessment
that is made, and then they are appropriately either funneled
into the psychiatric community or funneled into some type of
psychological services versus being criminalized, versus being
incarcerated.
So the bottom line is that we want to help people, and the
choice is always do we want to go to jail or do we want to go to
a psychiatric emergency room? If they are mentally ill, we want
them to go to a psychiatric emergency room because we want
them to really be serviced effectively and be misguided or
misdirected into the criminal justice system.
So CITs work, and the Memphis model is one example, the
Memphis Police Department. It has been very effective.
HOST: What strategies can be used for intervention and
rehabilitation?

8. DR. TELESCO: Crisis intervention teams don’t exist in every
police department. Some police departments have them and
some don’t, but clearly all police departments are training their
officers in (A) how to recognize mental illness; (B) how to
respond effectively; and (C) that safety is paramount above all
things, that deadly physical force is going to be used as a last
resort. Many, many times police officers are handling and
responding to people with mental illness effectively. Nine times
out of ten, they are – it’s effective.
One time where it is not effective is when we’re using deadly
physical force against a person who is mentally ill, and that is a
tragedy. We want to avoid that because that is not helping. That
is not an effective intervention. That is not a rehabilitative
strategy, for sure. Sometimes these things can’t be avoided.
Sometimes, and that is the tragedy behind it, a person who is
mentally ill who is a danger to themselves or others and that
danger is manifesting itself right then and there with the police.
The police feel in danger and they feel that their lives are in
danger, and then they might use deadly physical force. That is
the last resort, and we never want to really see that happen
because the safety of all persons is paramount.
However, if we can effectively intervene at the scene when
someone is mentally ill and bring them safely and effortlessly to
a psychiatric emergency room, or to be assessed by a
psychiatrist or a psych nurse, then that is a good ending because
then that means that this person is going to be receiving the care
they need. Because that is what this is about.
We go back to Week One when we talked about human service
delivery. First of all, the dignity of all human beings is
paramount so we want to make sure that we’re responding with
dignity. We want to make sure that we’re responding with
safety, and we want to make sure that ultimately, the goal is
that this person receives help.

9. A lot of the CIT programs have been very effective in
accomplishing that mission. Now, some police departments
can’t afford that because it is a costly program and is also hard
to coordinate. We’re talking about the mental health community
coordinating with the police community, and there are a lot of
reasons why some police departments don’t have CIT programs.
But every police department trains their officers in how to
effectively intervene in a mental health or mental illness
situation.
HOST: Consider these concepts as you read your materials,
complete your assignments, and answer this week’s discussion
questions. Follow up with your instructor if you have any
questions.
[End Audio]