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Communication difficulties with emotionally disturbed people

By Dennis L. Conroy, Ph.D.
Sponsored by KRM Information Services

Dealing with the emotionally disturbed has always presented a quandary for law enforcement.  Individuals suffering from mental illness are often those who suffer immensely, and as such, elicit sympathy from the rest of the population.  All of us can look at their condition and be glad we are not suffering from a similar affliction.  Yet the mentally ill person poses unique threats to police officers. 

Often the very nature of the illness causes a unique unpredictability in the behaviors and response of these individuals.  While most mental illness do not involve a psychosis, or a complete loss of contact with reality, difficulties in communication still pose a significant risk for police officers.  It is like trying to communicate with someone where there is not necessarily any basis for communication. 

We take certain things for granted in our day to day communication that may not be true when dealing with an individual suffering from a mental illness.  The mental illness may well involve perceptual difficulties or even hallucinations.  While attempting to communicate with an individual who is extremely paranoid, even the simplest statements can be misinterpreted and heard as accusatory or persecutory.  This becomes exceptionally problematic when attempting to build trust in a crisis situation. 

In cases where the mental illness is more severe and there are delusions or hallucinations involved communication becomes even more difficult.  Delusions may cause an individual to believe that he is endowed with special powers and entitled to specific kinds of treatment.  He may believe that he is the world’s greatest athlete or scientist.  The police officer may not be aware of these beliefs and no matter how polite, courteous, and professional the officer is, the individual can still feel as though the officer is being disrespectful because of his perceived status in life. 

An individual who is suffering from dementia may not be able to process an officer’s instructions or requests.  As the individual is unable to process these communications there may not be an appropriate response, often leading to an escalation in the intensity of the officer’s communication.  While the individual is perceived as being unresponsive by choice, it may well be that he is unresponsive because he does not understand even the simplest of requests.

An individual undergoing a psychotic episode may have lost all contact with reality.  They may not even be able to identify officers as police officers even though the officer is in full uniform.  There have been cases where the psychotic individual has mistaken police officers for North Vietnamese Regular soldiers, or as soldiers from the “army of Satan”.  It is exceptionally difficult to establish a basis for communication in these cases.  The psychotic individual is often overcome with fear and is responding to what they see, rather than what is. 

When attempting to communicate with someone who is mentally ill, go slowly.  Don’t assume anything, don’t take anything for granted.  You cannot assume the individual identifies you as a police officer just because you are in full uniform. You cannot assume they know they are mentally ill or that you have their best interests at heart.  You can’t even assume they are oriented to the current time and place.  Therefore, it is essential to communicate carefully.

Here are some tips for communicating with someone who is mentally ill.

1. Protect yourself – don’t take unnecessary risks
2. Go slowly
3. Paraphrase and repeat back what they are telling you
4. Don’t issue orders unless there is an immediate danger to life
5. Take a “soft” approach whenever possible
6. Don’t take shortcuts unless absolutely necessary
7. Don’t forget, you may be dealing with this person again and they will remember you.

Dr. Conroy has a Ph.D. in Clinical Psychology, has a private practice and consulting business, and is a recently retired 30-year veteran Sergeant with the St. Paul (MN) Police Department.



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