How to Talk to the Mentally Ill

There’s not enough underpaid mental health professionals to go around, and family members eventually reach their own breaking points. This leaves society’s de facto field shrinks—that’s you, my brothers and sisters—to deal with those who spend more time listening to the voices inside their head than they do voices of reason.

Author Dean Scoville Headshot

The following is a real conversation that I had with a mentally ill person:
"You s*** your pants."
"I did not!"
"Yes, you did. You s*** your pants!"
"No, I didn't."
"Oh, yeah? Drop your pants.”
(Does as told.)
"Eeewww! See? I told you."
"Oh, I thought you were talking about today."

Working patrol, you are apt to encounter any number of pathetic souls whose emotional states are not what they should be. For my part, I found myself occasionally rolling to one of our local mental health facilities. Usually, it was in response to some out of control non-conformist whose lapsed health insurance guaranteed her some cut-rate mental health intervention. I’d end up trying to talk the poor little wing nut out of killing herself; trying to beat the crap out of the mental health staff, or spewing verbal and physical assaults at my deputies, or—most importantly—me.

Having some success toward this end was counter-intuitive. I don't suffer fools gladly and will never be known for my interpersonal skills. But give me a dingbat, a wacko, a "51-50” per California code, and watch me rock and roll. Often, I was able to develop a rapport and persuade them to go along with the program.

Part of this may have been my ability to relate to them. Sharing the same warped wavelength, I don't understand the world; the world doesn't understand me. It's a convenient marriage.

Still, the inherent irony to the situation—authority figure and historical irritant to 51-50s the world over succeeding where the alleged experts failed—wasn’t lost on me.

And so I suspect that my undesired empathy with the emotionally compromised also played a role: my father was a paranoid schizophrenic. Dealing with his altered states of mind gave me some understanding for what many family members and doctors have to deal with.
What the hell does this have to do with you, oh, Keeper of the Peace? Well, for one, there’s not enough underpaid mental health professionals to go around, and family members eventually reach their own breaking points.

This leaves society’s de facto field shrinks—that’s you, my brothers and sisters—to deal with those who spend more time listening to the voices inside their head than they do voices of reason. It means more and more confrontations between cops and society’s more emotionally compromised—confrontations that lead to members of each side of the equation getting killed.

That’s why if you have a chance to engage these lost souls in a dialogue before the bad stuff hits the rotary oscillator, you should make the most of it.

Now, what I’m offering here hasn’t been signed off by the American Psychiatric Association, been deemed appropriate intervention techniques by the National Mental Health Association, or published in the Journal of the American Medical Association. Indeed, ideally, such situations should be resolved by a Crisis Intervention Team (a sincere thank you to Memphis, Tenn.).

But, hey, these strategies have worked for me…

1. Contain the environment.
As what I’m offering here is predicated upon the understanding that the person isn’t armed, let’s keep it that way. Try to converse in an environment that has the fewest inherent dangers (Hint: chemical labs, knife shops, and gun ranges are out of the question). Have other personnel on hand should the need for physical intervention arise. Also, don’t try to have more than one person talk with the subject at a time. The person is already overwhelmed. Don’t make them more so.

2. Lower your voice.
Have as soothing a countenance as possible (hey, if I can do it, you sure as hell can, too).

3. Affect a non-threatening posture.
You’re already an authority figure, so you’ve got your work cut out for you in this area. Just remember, you don’t have to look like a shrinking violet, but try not to intimidate the person any more than necessary.

4. Find common ground.
This sometimes means humoring the disturbed individual about some of their delusions. If it seems that all they really want is for someone else to see where they are coming from, well, by God, do it (sometimes, it isn’t even a stretch).

5. Be as candid as you can be.
This rarely fails to 1) piss ‘em off, and 2) actually create some progress. When asked to do things that you can’t do, say, “I don’t want to lie to you. I can’t do that.” As disagreeable as that sounds, it actually fosters trust—and belief in you when you do tell them something else later. (Besides, if you subsequently *do* lie, you can still honestly say you didn’t want to…of course, you may have made things a little more difficult on the next roll out…).

6. Don’t patronize them.
“Just because I’m crazy doesn’t mean I’m stupid.” History will never lack for examples of the brilliantly compromised. But for a convenient contemporary reference point, the character portrayed by Tom Wilkinson in “Michael Clayton” is a great example (and, for the uninitiated, the film offers a good primer on the limitations for committing people against their will).

7. Ask them if they have any constructive solutions to their problems.
By allowing them to be part of the decision-making process, they may retain some impression of having some control of their circumstances. Note the emphasis on “constructive.” Note also that their definition of constructive may be different than yours.

8. Ask them to do you a favor.
Even if they’re not naturally predisposed to doing what you want them to do, the sensitivity of such individuals often means that they’re capable of some degree of sensitivity towards others. Putting them in the role of helping YOU can be empowering for them.

If you’re already practicing these strategies, great. I’ll not emulate the Verbal Judo guys and insult all the silver-tongued devils out there by proclaiming this a science and anointing it with its own nomenclature. Moreover, I’d really like to hear comments from others as to what has helped them handle such problems.

Finally, I don’t care if the guy is a 51-50 who’s having Vietnam flashbacks despite never having served in the armed forces. If he’s actively posing a threat to you or someone else, deal with him as you would any other person. Indeed, sometimes you might have to do a little more as they may be less vulnerable to the usual inducements.

Believe me, there’s something mutually pleasing when you find your little wing nut strapped down on a gurney, agreeably beaming with the semi-lucid understanding that he has successfully disrupted the daily lives of a few cops and firemen at minimum personal expense.

Your results may vary.

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Author Dean Scoville Headshot
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