Like, handicapped or something

[Flea]

I proudly chair the Board of my city's chapter of DBSA - the Depression and Bipolar Support Alliance. As our group has grown, we've expanded our circle of interest beyond recovery to include things like political advocacy, civil rights, and combining clout with other minority communities. It's a great day for us, and I'm thrilled to be at the helm.

Recently I came across a study by the DOJ that people with mental illness are 11 times more likely to be victims of violent crime than the general population. Sounds like a call to action to me! So I set up a presentation during tomorrow's meeting for an officer to give a generic talk on personal safety and crime prevention. Who can't use a refresher on that? I talked with a very nice officer a couple weeks ago who understood very clearly what we needed. Today I called to confirm with him, and it's a good thing I did. He had delegated this to someone else who had no idea what our group was about, where we met, or what I wanted them to talk about. He asked me what demographic he'd be talking to, and I laid it out - a support group for people with mental illness.

"So, are they like, handicapped or something?"

*sigh*

I wasn't mad, I get that all the time. It's why I do this - there are so many stereotypes to dispel, so very much work to be done. I think he understood what kind of presentation I was asking for. I just hope he doesn't talk down to us. Our membership includes a few engineers, an attorney, a research biologist, and a former journalist. Should be interesting. %-}

My city has a CIT (Crisis Intervention Team) that's top-notch. It's tough, but I'm trying to find ways to build a direct relationship between them and the community of "consumers." Classroom training is great, but real empathy and respect comes from knowing someone personally. I'm not talking about having someone over for Christmas Dinner, but a little face time can go a long way.

Are there any CIT officers here? I'd be interested to know what kind of direct contact you have with the mental health community in your town. And how the whole department in general is trained on these issues. If you'd indulge me here, I hope it will make me a more effective community leader.

Thank you.

*edit*

Having read back over this, I realize it has nothing to do with MA and is therefore off-topic. I'll bow to the mods on this, but I hope you'll let it stay because it's an issue that's very near to my heart. I think a constructive conversation on this will be profitable not only for me and my community, but for others too.

 

[Bruno@MT]

I am perhaps unqualified to give my opinion on this, but I lived for 6 years in a city that is famous for its live-in care for people with mental illness (Geel, Belgium) I am not going to bore you with the historical background of how this came to be, but Geel has a large number of houses where people with a mental illness live together, as independently as their illness allows.

One of the important reasons that this works and that these people are relatively left alone, is the awareness of the general population.

I shouldn't use the word 'everybody' lightly, but the vast majority of the general population knows 'their' people. And this matters a lot because people don't really look up for people doing 'weird' things. Weird behaviour is considerd expected->doesn't draw much attention -> they are mostly left alone.

Additionally, many people keep an eye out for such people and help them if there is a problem. I have done that myself a couple of times (bringing someone home when they fell on the street etc)

I think that your plan should cover 2 things
1) educating people with mental illness.
2) raising awareness within the general population.

if you can make headway with (2), then people with mental illness will be less likely to become victims because they will lose some of the 'strangeness factor', plus people might start watching out for them.

I know it worked fairly well in the city I lived in, but I realize that is in part because they have been part of the community for more than a century.

 

[Drac]

They actually have classes of dealing with the Mentally Handicapped that we in the LEO community have to attend..

 

[Flea]

Good to know. What do they teach, if you don't mind my asking?

I guess what I'm hoping for is some kind of empathy/sensitivity training, rather than just perusing the DSM4. For instance, Janssen developed a virtual reality program several years ago simulating a psychotic break:

http://www.janssen.com/janssen/mindstorm_video.html

They made two versions, one for law enforcement and one for "loved ones." I would love to see it myself. Every so often I contemplate what a parallel program would be like for depression or OCD - it doesn't lend itself so well to virtual reality, which is a shame.

At any rate, I thank you both for your responses. I'd love to keep this going.

 

[Drac]

Good to know. What do they teach, if you don't mind my asking?

I guess what I'm hoping for is some kind of empathy/sensitivity training, rather than just perusing the DSM4.

Yeah it was that...The problem here is we dont see too many victims we see A LOT of suspects...I have no idea what the DSM4 is....

 

[Flea]

I have no idea what the DSM4 is....

The Diagnostic Statistical Manual is literally the textbook by which doctors diagnose mental illnesses: http://allpsych.com/disorders/dsm.html It takes years to compile, and they're working on a DSM5 right now. I think the estimated release date is 2012.

Anyway.

When you say "victims," do you mean crime victims, or people with diagnoses? We had our meeting last night, and one surprise that came out of it was that a lot of us are reluctant to make calls for service because we expect not to be taken seriously. Especially for someone who's been hospitalized involuntarily; it's reasonable to assume that your name has been entered into some database somewhere as a potential future problem when you've been carried off by police.

I'm also curious about your definition of "suspect" in this context. I assume you mean the "suspect" is the one with the illness. Would erratic but non-criminal activity qualify someone for that term? If so, I can see how that would contribute to the social stigma; words are very important in crafting attitudes and ideas.

The meeting went pretty well. The officers were very professional and respectful, although I heard one of them mutter "Oh my god!" when he saw the standing room-only crowd. :uhyeah: We have that every week. We had the same questions they hear at every presentation they give, with the exception of "will they take us seriously if we ask for service?" and "is it true that people with mental illness can't get guns?" Their answers were Yes, and I have no idea. I think that second question caught them off guard, but it's a very valid one. Especially since poverty forces some of us to live in seedy neighborhoods.

I definitely want to do this meeting again some time.

 

[Drac]

The Diagnostic Statistical Manual is literally the textbook by which doctors diagnose mental illnesses: http://allpsych.com/disorders/dsm.html It takes years to compile, and they're working on a DSM5 right now. I think the estimated release date is 2012.

Thanks.

I'm also curious about your definition of "suspect" in this context. I assume you mean the "suspect" is the one with the illness. Would erratic but non-criminal activity qualify someone for that term? If so, I can see how that would contribute to the social stigma; words are very important in crafting attitudes and ideas.

I get a call for service of someone creating a public disturbance..Upon my arrival I see someone matching the broadcast discription..He is a suspect in that call..

 

[Flea]

I get a call for service of someone creating a public disturbance..Upon my arrival I see someone matching the broadcast discription..He is a suspect in that call..

Well that makes sense. I'm sorry if I put you on the defensive, that wasn't my intention. I'm trying to understand how these things are done from the other side.

So if I may continue on this line ... as a non-psych professional, how would you make the determination as to whether a mental health issue is involved in a given situation? And once you do, what is your department's protocol on where to go from there?

 

[Archangel M]

If a persons actions present a danger to himself/herself or others most states have "mental hygiene" laws that can give the officer the option of mandating the subject receive care at a medical facility, with or against the subjects will.

If the persons actions are not a danger then it becomes an issue of whether a law has been broken or not. Mental illness may be a defense in court but not on the street. It is important for officers to be able to recognize mental illness in order for them to deal with the subject in the safest manner possible for the subject and himself.

Im not implying that anybody here thinks this...but some people think that officers need to be able to recognize mental illness so that they wont arrest someone who suffers from it, and thats not really the case in most events. It may help the officer to use discretion in cases where arrest may not be necessary as in simple disorderly conduct events, but if there is a victim the will most likely be an arrest.

 

[Flea]

I would have to agree with all of that. A broken law is a broken law. And while there are degrees of deviation, your job is to enforce the law as it stands.

I guess what worries me is how the social stigma involving mental illness might affect an officers' decision-making or attitude at the scene. That fear and derision is a deeply ingrained cultural belief going all the way back to the days of "demon possession," and can potentially make the difference between life and death for a subject during a stressful moment.

A few days of sensitivity training aren't going to undo the stigma, but it's gratifying to know the effort is underway. I thank you all for the information, and wish you well.

 

[Drac]

Well that makes sense. I'm sorry if I put you on the defensive, that wasn't my intention. I'm trying to understand how these things are done from the other side.

Not on the defensive...

So if I may continue on this line ... as a non-psych professional, how would you make the determination as to whether a mental health issue is involved in a given situation? And once you do, what is your department's protocol on where to go from there?

Any office that has worked the streets can spot someone with mental health issues..There are a number of local hospitals with psych wards that they can be transported to...

 

[Flea]

Any office that has worked the streets can spot someone with mental health issues..

Aaaah, there's the rub. Thank you for articulating that. That's a large part of what I was trying to get at.

Speaking from personal experience, that simply isn't feasible. Anyone who's been in treatment can tell you just how easy it is to fool a psychiatrist or therapist. Why shucks doc, I'm not suicidal! There was a case in my city a few months ago where a man who had been in hospital for a full week hanged himself; in the ensuing investigation a host of therapists said with a straight face that he had only threatened suicide five times, so how could they have known to take him seriously? If even a specialist can be that clueless, what chance can a minimally trained officer have when forced to make a split-second call?

On the other side of the equation, erratic behavior doesn't always denote mental illness either. This can be a cultural question with a recent immigrant, for example, or someone who's pig-headed enough to expect everyone to accommodate his eccentric behavior.

Add in the fact that hospitals will involuntarily hold someone brought in by the police 80% of the time, and you have a very compelling reason for anyone to actively avoid psych treatment of any kind. With a statistic like that it's a natural for equate treatment with punishment for breaking social norms. Who wants to be punished?

 

[Bikewr]

Our goal is to have the entire department CIT certified; we are about 85% right now. I went through the 40-hour course 2 years ago, and had a refresher course last year.

Here in Missouri, and in St. Louis in particular, the mental health community suffers from severe lack of funding. The resources for "consumers" (that is to say, consumers of mental-health services) are very limited, and rely on volunteers and donations to keep running at all.

That being said, we have a very active CIT program, good relations with all the community, a monthly newsletter, and "Mental Health Court" pilot programs that have shown great promise.
The previous state administration was extremely stingy with mental-health funding, and made cuts in already-strapped programs; very sad.

Hopefully, the newly-elected governor will change priorities a bit.