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 persons

Thinking Feeling Mood Ability to relate to others Daily functioning

Whats 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 societyany 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:

Canand willvary. 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 cant 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 persons 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 isnt 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 isnt 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 dont 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 mothers capacity for coping with the ordinary demands of life.

Is not baby blues

Suicide
The taking of ones 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 dont 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. Its 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 theres 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. Whats 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 dangerousnesscont.

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