What mentally ill subjects want cops to know
As part of an extensive training video on successfully communicating with difficult subjects, a Force Science Institute team led by executive director Dr. Bill Lewinski recently interviewed mental patients regarding their encounters with police in crisis situations.
"What would these subjects most want officers to know about relating to them?" the team asked. "From the perspective of a person in emotional turmoil, what fundamental attitudes and behaviors by the police are most likely to defuse a volatile situation and keep it from escalating into violence?"
Answers from half a dozen men and women with mental illnesses are included as part of a 112-minute instructional video on communication skills called “Communication and Persuasion,” produced exclusively for the Metropolitan Police Federation of London, England, to assist in its training programs.
Each of the interviewees has experienced interactions with law enforcement during periods of extreme distress. Their consensus is that officers and subjects alike would benefit from LEOs embracing three core concepts when dealing with the mentally ill.
1.) Understand Us. To establish effective communication, you need first of all to appreciate what the subject is going through and what hidden forces may be influencing his or her behavior. “It’s very scary to be mentally ill,” explains “Janey,” a schizophrenic.
“Peter,” a middle-aged man who has suffered “extreme mental health episodes” since he was seven, hears “external and internal voices,” sometimes as many as 20 or 30, “all shouting in a melee together, talking about you, urging you to do something, or just being critical.”
During manic events, “Liz,” a bipolar subject, says she “flips into someone I don’t know.” She feels “very high, to the point of losing all inhibitions,” perceives herself as “inappropriately confident,” and doesn’t “care what I say to people or what the repercussions are.” Her head feels like it’s “going to explode from so many rushing thoughts.”
“Selena,” a suicidal subject who once confronted police with a kitchen knife clutched in her hand, talks about “just wanting the pain to end.” In her dark moments, the perception that life is not worth living has “complete control of me, coming from the pit of my stomach.” Killing herself then seems an “appealing” way to get rid of overwhelming pain and anger and to “be calm once and for all.”
In establishing dialog as a responder, once you have the subject’s attention, some empathetic questioning may offer insights into the state of mind you’re dealing with — how they see their crisis, and how they see you: “What are you experiencing? What’s going on for you at this moment in time?”
2.) Respect Us. Such questions can help convey the impression the subjects seem most to desire from the police: the sense that you “actually care” about them and what they are experiencing. “Devon,” a paranoid schizophrenic who says he appreciates an “amiable attitude” by officers, elaborates:
“Treat us as human beings, as a person speaking to another person, with the emphasis on the person and finding how you can help that person. Listen to what we’re saying.”
Liz favorably recalls a female officer who “took me into her car and spoke to me like I was human, not like some sort of complete nut case. It was like a girly, girl-on-girl chat and made me feel really comfortable and relaxed.”
By contrast, “Jordan,” a young man with obsessive/compulsive disorder, was confronted by an insensitive officer while being treated at a medical facility for a drug overdose. “He didn’t introduce himself and was very intimidating. He made me feel guilty for what I had done.” That “got my back up,” he says, and left him determined not to be compliant the next time he encounters police.
3.) Calm Us. Telling a highly agitated subject to calm down “will be totally ineffective,” Liz observes. To encourage communication and cooperation, you need to model calmness and control and to understand what’s likely to be settling or disturbing to a mentally troubled individual.
For example, Liz was calmed by the friendly chat with the female officer, but then when the officer “put the siren on and started speeding off” to get Liz to a treatment facility, “it was the worst thing she could have done because I panicked and it set me off into mania again.”
Likewise, arguing with a mental subject or trying to “correct” their delusions will also be counter-productive.
You’re best off, the interviewees say, to remove or try to minimize stimulating distractions: gathering crowds, loud noises, flashing lights, fast traffic, etc. “If you can get me to a quiet place, it’s much easier for me to work out what’s going on,” says Janey.
“If I’m hearing voices, I do hear people in the real world as well. But they’re mixed in with the other voices, so if I can also see you and see your mouth it’s really helpful in figuring out who’s in the real world that I’m supposed to be talking to.”
She and others speak of wanting “extra physical space” and of not wanting to be touched when they’re in crisis. “When I’m not well,” Janey says, “I find it very, very difficult to have anyone up near me and really disturbing being touched by anyone. I’m much less able to control lashing out than when I’m normal.”
Calming and a projection of empathy are important factors in dispelling the predominant negative emotion mental subjects are likely to feel regarding the police: fear.
“A congenial approach will not work for every subject in every situation,” Lewinski notes, “but unless immediate forceful control is necessary, an approach that emphasizes rapport-building and persuasion can lead to a satisfactory resolution without injury to either officers or mentally disturbed subjects.”
The video was filmed and edited in London under the direction of Jane Sayers of Mojo Productions, who has worked on other Force Science projects. In addition to the subject interviews, the program covers techniques for reading people, active listening, building rapport, tactical questioning, persuasion, and preventing in-custody deaths. It will be used as a critical part of communications courses for law enforcement throughout the United Kingdom. Please note that copies of this video are not available outside the UK police system.