Justice For Mental Health (and homework for Matt Gurney) UPDATED

Having a Twitter back-and-forth with Matt Gurney about police and identifying mentally ill individuals.

Gurney makes a good point that no matter what, officers will have to handle the person in front of them, regardless of what the backstory is - and they won't necessarily have oodles of time to decide what's motivating behaviour (illness, drugs, a stressful day).

Here are a couple of ideas I put down that eventually morphed into a slide deck that isn't so postable to a blog:

JUSTICE FOR MENTAL HEALTH

THE REALITY

•       Front line police officers are often first and last responders to Emotionally Disturbed Person (EDP) calls

•       Without appropriate supports and education for police, these calls carry an unnecessary risk for both officers and EDPs

–      Post-Traumatic Stress (PTSD) for officers with impact on their work, health and families

–      Avoidable incarceration, injury and fatalities for EDPs

•       Toronto officers receive annual mental health training as part of a two-day “use of force” program.  Training includes role-play but no exposure to persons with lived mental illness experience or education about the biology or behaviour of mental illnesses

THE OPPORTUNITY

Expand existing Police training and provide additional online support tools

Training:

·         Resiliency and stress management

o   (potential partners: Millbrook Canada, Centre for Applied Neuroscience Canada (CANC), Justice Mental Health Program (JAMH), Canadian Positive Psychology Association (CPPA)

o   Basic training regarding brain function and abnormal psychology (CANC + JMHA)

·         Exposure to EDPs in safe environments (eg. Rounds at CAMH)

Online Support Tools:

·         Modularized online training (including videos presenting behaviour of psychological conditions for exposure)

o   Modular E-Learning programs would reduce manpower lost to training time issues

·         Online map-based portal aggregating all Toronto mental health, health and related justice service providers

·         Smart-phone App that provides an easy-to-navigate chart of mental illnesses, symptoms, conditions, triggers and suggested responses (developed in conjunction with E-Learning program)

ACTION ITEMS

-          Develop a pilot program (including model web portal/App) for  Toronto Police Divisions 51 + 52 (build on existing Mobile Crisis Intervention Team program)

o   Partners; Toronto Police, City of Toronto, additional mental health service providers


UPDATE - Look at this, there is already solid material out there that could be followed up on:

HALLUCINATIONS:

“My hallucinations are not always there but when I see and hear imaginary things, it is very frightening and painful to me. I know some people think I can just control myself and tell myself they are not real. But I can’t will them away. They are real to me when I am experiencing them.”
– CLIENT

Definition:
Person senses perceptions that do not exist in the real world such as:
- feel such as bugs crawling under the skin
- smell such as smoke or gas
- taste such as poison in food
- sight such as visions of God, other persons, etc.
- hearing such as voices telling the person to do something auditory the most frequently encountered hallucination involves the auditory sense, i.e. hearing


Recognition:
• has faulty sensory perceptions, i.e., hears, sees, smells, feels things that do not exist
• talks to self
• appears preoccupied and unaware of surroundings
• has difficulty following conversations and instructions 
• momentary or extended lapses in attention, as if listening to something
• misinterprets words and actions of others
• may isolate self 

• may use radio or other sounds to tune out voices

Police Response Strategies:
• isolate and contain
• do not invade personal space 
• do not touch without permission or stand too close
• speak slowly and quietly using simple concrete language
• avoid verbal confrontation
• remember it may take the individual longer to process information
• instruct to “listen to my voice, do not listen to the other voices”
• explain your actions
• ask questions:
    – “Are you hearing voices other than mine?” 
    – “What are they telling you?” 
    – “What do you see, feel, taste?”
• reduce confusion, i.e., bright lights, television, radio
• be aware that stress may increase hallucinations
• address the person by name/if do not know it, ask how they would wish to be addressed

• do not pretend that you are experiencing the hallucination along with the person

Remember – you are the grounding in reality. Respond by saying, “I don’t hear the voices, but
understand that you do.” It is critical to ask questions regarding the content of the message in that it may be a directive to hurt someone including you. Try to get a sense of how they feel and how you could help. 

Remember – the person may not be able to adequately process the information or may have recent memory problems making it difficult to follow instructions.


UPDATED:  “Real life in the police services is not a television drama,” wrote Blair near the end of the ruling. “What took place here sullies the reputations of the many good officers in our country, whose work is integral to the safety and security of our society.”