4 - Part 2 - Mental Illness
Content
OAKLAND POLICE DEPARTMENT
Part 2 Mental Illness
[Chapter 4]
Learning Domain #37 Persons with Disabilities Officer D. Neff
Introduction: Mental Illness is a biologically based brain disorder which cannot be overcome through will power.
Mental Illness is not related to intelligence or character
Mental illnesses are medical conditions which disrupt a person’s…
Thinking Feeling Mood Ability to relate to others Daily functioning
What’s the most common form of mental illness?
Depression
Who does depression affect most?
Women and Children
When mental illness is NOT addressed…
What are the consequences for society?
Unemployment Substance Abuse Homelessness Inappropriate Incarceration Suicide
What is the monetary cost to society…any idea?
$100 Billion in US per year
Can Mental Illness be cured?
No… but…
It can be Managed Maintained Controlled Treated…
…and people reach recovery everyday.
How?
For a successful individual treatment program someone needs… • Acceptance • Medical Treatment • Psychological Treatment Interpersonal / Cognitive Behavioral Therapy • Peer Support • Meaningful job / volunteer position • Diet • Exercise • Sleep • Availability, accessibility and funds for medication
Who does Mental Illness Affect?
Gender? Race? Socio-Economic Status?
Age?
Symptoms of a Mental Disorder:
Can…and will…vary. Every person who is affected by a mental disorder is different.
Often symptoms of mental disorders are cyclical… varying in severity from one time to the next.
The duration of an episode also can vary; weeks or months and this may last years or even a lifetime.
THOUGHT DISORDER
A condition where the persons thought process is disrupted causing that person to experience delusions or irrational fears, See visions, or a number of other irrational behaviors.
Schizophrenia
Truth or Myth
•
Individuals with schizophrenia all have the same symptoms.
People with schizophrenia are dangerous, unpredictable and out of control. Cognitive decline is a major symptom of schizophrenia. Schizophrenia develops quickly. Schizophrenia is purely genetic. Sufferers need to be hospitalized. People with schizophrenia can’t lead productive lives. Meds makes sufferers zombies / Antipsychotic meds are worse that the illness itself. Individuals with schizophrenia can never regain
•
•
• • • •
•
•
Schizophrenia
A group of related disorders in which a person’s ability to function is marked by severe distortion of thought, perception, feelings and bizarre behaviors.
Behaviors associated with Schizophrenia:
Impaired Self Care
Hallucinations:
A false perception experienced through any of the 5 senses with little or no awareness of their surroundings.
Something a person sees, smells, hears and feels that isn’t really there.
Most common: hearing voices
Oprah and Jani
Video Clip
Delusions:
A persistent false belief or thoughts and actions not based in reality.
A false belief that isn’t true.
Bride of Christ
Video Clip
Disorganized Speech:
Rapid flow of unrelated thoughts
Disorganized Thought Pattern:
Inability to make logical thought connections or concentrate
Fruitvale and International
Video Clip
Disorientation:
Abnormal memory loss related to name, date, and location
Schizophrenic Episode:
Video Clip
Thought Disorders:
Threat Assessment and Communication / De-Escalation
Test:
Video Clip
How can you recognize if a person is hearing voices or delusional?
He
or she is pre-occupied Talks to himself/herself Has difficulty understanding or following conversations or directions Is telling a bizarre story More??
Paranoid delusions are usually evidenced by extreme suspicion, fear, isolation, insomnia, avoidance of food and/or medication or sometimes violent actions. and A person experiencing paranoid delusions has extreme difficulty trusting others, will misinterpret others words or actions and experience ordinary things in his or her environment as a threat.
Goals of the interaction…
Help the person focus on reality rather than the hallucination or delusion Do not pretend you also experience the hallucination or delusion
Do not try to convince the person the hallucination or delusion does not exist...it does to them
Communicate:
Ask questions: Are you hearing other voices other than mine?
Tell the person: I don’t hear the voices, but I believe you do. Encourage the person to look, talk to only you. Reassure them that you are there to help them.
Basic Rules for Intervention:
Review Handout
Mood Disorders
A condition where the person experiences periodic disturbances in mood, concentration sleep, activity, appetite or social behavior.
Mood disorders can be marked by periods of extreme sadness (depression) or excitement (mania). Mood Disorders tend to be episodic.
Depression
A reoccurring disorder marked by sadness, inactivity and self-deprecation.
Common Behaviors Feelings of extreme rejection Persistent gloom Loss of hope Sense of worthlessness Mood Swings Feelings of guilt Occasional hostility Thoughts of suicide - ideation
Bipolar Disorder
A mental disorder characterized by rapid and unpredictable mood swings from mania to severe depression
Behaviors associated with Bipolar Disorder:
Irritable, angry or restless Talking fast and having racing thoughts you can not control Being easily distracted and unable to focus on one activity Feeling powerful and important and acting overly confident Requiring little to no sleep Acting impulsively and using poor judgment
A Beautiful White Buick Riviera with Gold Trim
Video Clip
Post Partum Psychosis:
A severe depression experienced by approximately 1 in 1,000 women after giving birth. Symptoms:
Can substantially diminish the mother’s capacity for coping with the ordinary demands of life.
Is not “baby blues”
Suicide
The taking of one’s own life.
Statistics:
Events are significantly higher for people who are affected by all forms of depressive disorders.
90% of individuals who die by suicide have a diagnosable mental illness
1.People who talk about suicide don’t do it; Suicide happens without warning. 2. Talking about suicide may give someone the idea.
3. Once a person is suicidal, he/she is suicidal forever. 4. If a person really wants to kill himself/herself, no one has the right to stop them. 5. There is no genetic predisposition to suicide.
6. Improvement following a serious personal crisis or serious depression means the risk of suicide is over. 7. It’s unhelpful to talk about suicide to a person who is depressed. 8. Suicidal people are fully intent on dying.
9.People who attempt suicide just want attention.
Situational Clues:
Rejection by a loved one Unanswered separation or divorce Recent unwanted move Death of a spouse, child or friend Diagnosis of terminal illness Sudden unexpected loss of freedom Anticipated loss of financial security
Suicide Warning Signs
Withdrawing from family and friends Performing poorly at school Acting impulsively / recklessly Feeling excessive guilt or shame Change in eating / sleeping habits Increased use of alcohol or drugs Feelings of strong anger or rage Feelings of being trapped – there’s no way out of the situation
Assessment:
Family History of suicide? History of previous attempts? Specific plan formulated? Ask about one. Recent loss? Death, divorce, move, etc. What’s happening at home? Abuse, neglect etc. Anniversary of traumatic loss? Psychotic?
Drug or Alcohol on board? Living alone, isolated? History of unsuccessful medical treatment? History of depression? Birth of child? Wanted vs. unwanted. Putting personal affairs in order? Radical shifts in behavior? Preoccupation of episode of physical, emotional or sexual abuse. Feelings of helplessness / hopelessness
When someone is depressed…
What is a common behavior / choice?
Dual Diagnosis
Co-Occurring
Dual Diagnosis
Co-Occurring Disorder
Police Response to 5150 calls involving someone with a mood disorder
5 Basic Steps for Intervention
1.
2.
3.
4. 5.
Make contact rapidly and establish the relationship Identify the scope of the problem in order to define it and assess for danger Generate and explore alternatives and specific solutions Develop and implement an action plan Follow up
What would limit a person who showed signs of a mood disorder ability to respond appropriately to police commands?
Difficulty thinking, concentrating or remembering Physically slow Agitated Loss of reality Psychotic
Indicators of dangerousness
Degree of Reaction
Indicators of dangerousness…cont.
Inappropriateness of behavior
Indicators of dangerousness...cont.
Extreme rigidity or inflexibility
Considerations:
Meds Diagnosed mental illness History of Violence Use of substances Support system Severity of symptoms
Part 2 Mental Illness
[Chapter 4]
Learning Domain #37 Persons with Disabilities Officer D. Neff
Introduction: Mental Illness is a biologically based brain disorder which cannot be overcome through will power.
Mental Illness is not related to intelligence or character
Mental illnesses are medical conditions which disrupt a person’s…
Thinking Feeling Mood Ability to relate to others Daily functioning
What’s the most common form of mental illness?
Depression
Who does depression affect most?
Women and Children
When mental illness is NOT addressed…
What are the consequences for society?
Unemployment Substance Abuse Homelessness Inappropriate Incarceration Suicide
What is the monetary cost to society…any idea?
$100 Billion in US per year
Can Mental Illness be cured?
No… but…
It can be Managed Maintained Controlled Treated…
…and people reach recovery everyday.
How?
For a successful individual treatment program someone needs… • Acceptance • Medical Treatment • Psychological Treatment Interpersonal / Cognitive Behavioral Therapy • Peer Support • Meaningful job / volunteer position • Diet • Exercise • Sleep • Availability, accessibility and funds for medication
Who does Mental Illness Affect?
Gender? Race? Socio-Economic Status?
Age?
Symptoms of a Mental Disorder:
Can…and will…vary. Every person who is affected by a mental disorder is different.
Often symptoms of mental disorders are cyclical… varying in severity from one time to the next.
The duration of an episode also can vary; weeks or months and this may last years or even a lifetime.
THOUGHT DISORDER
A condition where the persons thought process is disrupted causing that person to experience delusions or irrational fears, See visions, or a number of other irrational behaviors.
Schizophrenia
Truth or Myth
•
Individuals with schizophrenia all have the same symptoms.
People with schizophrenia are dangerous, unpredictable and out of control. Cognitive decline is a major symptom of schizophrenia. Schizophrenia develops quickly. Schizophrenia is purely genetic. Sufferers need to be hospitalized. People with schizophrenia can’t lead productive lives. Meds makes sufferers zombies / Antipsychotic meds are worse that the illness itself. Individuals with schizophrenia can never regain
•
•
• • • •
•
•
Schizophrenia
A group of related disorders in which a person’s ability to function is marked by severe distortion of thought, perception, feelings and bizarre behaviors.
Behaviors associated with Schizophrenia:
Impaired Self Care
Hallucinations:
A false perception experienced through any of the 5 senses with little or no awareness of their surroundings.
Something a person sees, smells, hears and feels that isn’t really there.
Most common: hearing voices
Oprah and Jani
Video Clip
Delusions:
A persistent false belief or thoughts and actions not based in reality.
A false belief that isn’t true.
Bride of Christ
Video Clip
Disorganized Speech:
Rapid flow of unrelated thoughts
Disorganized Thought Pattern:
Inability to make logical thought connections or concentrate
Fruitvale and International
Video Clip
Disorientation:
Abnormal memory loss related to name, date, and location
Schizophrenic Episode:
Video Clip
Thought Disorders:
Threat Assessment and Communication / De-Escalation
Test:
Video Clip
How can you recognize if a person is hearing voices or delusional?
He
or she is pre-occupied Talks to himself/herself Has difficulty understanding or following conversations or directions Is telling a bizarre story More??
Paranoid delusions are usually evidenced by extreme suspicion, fear, isolation, insomnia, avoidance of food and/or medication or sometimes violent actions. and A person experiencing paranoid delusions has extreme difficulty trusting others, will misinterpret others words or actions and experience ordinary things in his or her environment as a threat.
Goals of the interaction…
Help the person focus on reality rather than the hallucination or delusion Do not pretend you also experience the hallucination or delusion
Do not try to convince the person the hallucination or delusion does not exist...it does to them
Communicate:
Ask questions: Are you hearing other voices other than mine?
Tell the person: I don’t hear the voices, but I believe you do. Encourage the person to look, talk to only you. Reassure them that you are there to help them.
Basic Rules for Intervention:
Review Handout
Mood Disorders
A condition where the person experiences periodic disturbances in mood, concentration sleep, activity, appetite or social behavior.
Mood disorders can be marked by periods of extreme sadness (depression) or excitement (mania). Mood Disorders tend to be episodic.
Depression
A reoccurring disorder marked by sadness, inactivity and self-deprecation.
Common Behaviors Feelings of extreme rejection Persistent gloom Loss of hope Sense of worthlessness Mood Swings Feelings of guilt Occasional hostility Thoughts of suicide - ideation
Bipolar Disorder
A mental disorder characterized by rapid and unpredictable mood swings from mania to severe depression
Behaviors associated with Bipolar Disorder:
Irritable, angry or restless Talking fast and having racing thoughts you can not control Being easily distracted and unable to focus on one activity Feeling powerful and important and acting overly confident Requiring little to no sleep Acting impulsively and using poor judgment
A Beautiful White Buick Riviera with Gold Trim
Video Clip
Post Partum Psychosis:
A severe depression experienced by approximately 1 in 1,000 women after giving birth. Symptoms:
Can substantially diminish the mother’s capacity for coping with the ordinary demands of life.
Is not “baby blues”
Suicide
The taking of one’s own life.
Statistics:
Events are significantly higher for people who are affected by all forms of depressive disorders.
90% of individuals who die by suicide have a diagnosable mental illness
1.People who talk about suicide don’t do it; Suicide happens without warning. 2. Talking about suicide may give someone the idea.
3. Once a person is suicidal, he/she is suicidal forever. 4. If a person really wants to kill himself/herself, no one has the right to stop them. 5. There is no genetic predisposition to suicide.
6. Improvement following a serious personal crisis or serious depression means the risk of suicide is over. 7. It’s unhelpful to talk about suicide to a person who is depressed. 8. Suicidal people are fully intent on dying.
9.People who attempt suicide just want attention.
Situational Clues:
Rejection by a loved one Unanswered separation or divorce Recent unwanted move Death of a spouse, child or friend Diagnosis of terminal illness Sudden unexpected loss of freedom Anticipated loss of financial security
Suicide Warning Signs
Withdrawing from family and friends Performing poorly at school Acting impulsively / recklessly Feeling excessive guilt or shame Change in eating / sleeping habits Increased use of alcohol or drugs Feelings of strong anger or rage Feelings of being trapped – there’s no way out of the situation
Assessment:
Family History of suicide? History of previous attempts? Specific plan formulated? Ask about one. Recent loss? Death, divorce, move, etc. What’s happening at home? Abuse, neglect etc. Anniversary of traumatic loss? Psychotic?
Drug or Alcohol on board? Living alone, isolated? History of unsuccessful medical treatment? History of depression? Birth of child? Wanted vs. unwanted. Putting personal affairs in order? Radical shifts in behavior? Preoccupation of episode of physical, emotional or sexual abuse. Feelings of helplessness / hopelessness
When someone is depressed…
What is a common behavior / choice?
Dual Diagnosis
Co-Occurring
Dual Diagnosis
Co-Occurring Disorder
Police Response to 5150 calls involving someone with a mood disorder
5 Basic Steps for Intervention
1.
2.
3.
4. 5.
Make contact rapidly and establish the relationship Identify the scope of the problem in order to define it and assess for danger Generate and explore alternatives and specific solutions Develop and implement an action plan Follow up
What would limit a person who showed signs of a mood disorder ability to respond appropriately to police commands?
Difficulty thinking, concentrating or remembering Physically slow Agitated Loss of reality Psychotic
Indicators of dangerousness
Degree of Reaction
Indicators of dangerousness…cont.
Inappropriateness of behavior
Indicators of dangerousness...cont.
Extreme rigidity or inflexibility
Considerations:
Meds Diagnosed mental illness History of Violence Use of substances Support system Severity of symptoms
