There are more than 300 mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders. Mental illnesses can affect people's thoughts, mood, behavior, and the way they perceive the world around them. This manifests itself at work, in relationships, or in everyday tasks; one in four adults experiences a mental health disorder in any given year. Overall, 5% of the U.S. population suffers from some type of serious mental illness. Combine this with the statistic that approximately 10% of people who suffer from mental illness eventually die by suicide, as compared with 1% to 3% of the general population, and it's easy to see that we as law enforcement officers need to take this topic very seriously.
Research suggests that people with developmental disabilities and other mental issues are seven times more likely to encounter law enforcement than others. An International Chiefs of Police Association (IACP) 2014 report found that 10 times more people affected by mental illness are in prisons and jails than are receiving treatment in state psychiatric hospitals. In other words, law enforcement officers often find themselves on the frontlines when dealing with people in a mental health crisis. Today's law enforcement officer is forced to act as a mental health worker in a system that is obviously broken.
It's interesting to note that even though the IACP has released a model policy on this topic, it is unclear how many of the 18,000 U.S. state and local law enforcement agencies have a policy of any kind. When an agency fails to address the issue, it leaves their officers to fend for themselves. Unfortunately, the headlines are filled with the failed outcomes of such a practice.
Mental illness is surrounded by stigma, fear, and discrimination. To help combat this, law enforcement created its own politically correct jargon. We use the term "emotionally disturbed person" (EDP) to describe a person with emotional, mental, or erratic behavior that affects their decision-making process that may include hurting themselves or others. In dealing with EDPs, one must use a variety of skillsets to de-escalate or defuse situations, requiring officers to communicate respectfully, practice active listening, and avoid stereotyping.
As in all encounters with the public, we must be respectful to the person. Experience teaches us that when someone feels respected, they are more likely to return respect and at least consider what you are saying.
Don't start any conversation expecting a confrontation. Approaching a person with your defenses up will likely make communication difficult. I highly recommend avoiding sarcasm and humor as they tend to be misunderstood by the person in crisis. Friendly but firm has worked for me in the past. Remember that everyone is different so what worked yesterday on Person A, may not work today on Person B.
If the EDP is experiencing hallucinations or delusions, understand that is the reality they are experiencing. It doesn't matter that the CIA is not after them; if they think they are, then they are. Do not expect to talk them out of their reality. Instead, you must try to communicate that you recognize what they are experiencing. Do not pretend that you are experiencing their situation as well or have done so in the past.
Do not assume that they are not smart and will believe anything you tell them. Mental illness has nothing to do with someone's intelligence level. Chances are also high you will see them again so don't lie; you will be found out and it will break any rapport you may have established, making your next encounter that much more difficult.
Practice Active Listening
Active listening implies listening more than talking. It's an important skill when there is something you are trying to achieve. Active listening is used in counseling, training, and conflict resolution. It originated from person-centered therapy theories found in psychology. Active listening requires you to fully concentrate, understand, and respond to what's being said. Providing feedback is critical to the process.
It's important that you acknowledge the person's emotion and not minimize it. Use paraphrasing to show when you understand what they are saying to you. You can also use summarizing to show understanding as well. Active listening is a way to get the person to trust you and give more weight to what you are telling them.
Stereotyping mental illness helps no one. For example, suggesting that people with mental illness are more dangerous and unpredictable is based in fear and not fact. Most people with mental illness never commit acts of violence and are actually more likely than others to be victims of violence.
There are surveys that suggest that only 3% of people with mental illness are violent. That means 97% of people with mental illness are not violent.
There is nothing wrong with using officer safety tactics and being prepared for the possibility of violence. But going into a state of hypervigilance because of bias, fear, and media fed stereotypes helps no one. Useful information from family, friends, and doctors beats stereotyping any day of the week.
Suggestions When Dealing With EDPs
Communication with EDPs is critical to defusing the situation. Here are some useful tips in no specific order.
- Remain calm and avoid overreacting. Where possible, eliminate emergency lights and sirens.
- Provide reassurance that the police are there to help.
- Speak simply and briefly, and move slowly so as not to excite the disturbed person.
- Remove distractions, upsetting influences, and disruptive people from the scene.
- Understand that a rational discussion may not take place.
- Recognize that the person may be overwhelmed by sensations, thoughts, frightening beliefs, or sounds.
- Be friendly, patient, accepting, and encouraging, but also remain firm and professional.
- Be aware that your being in uniform may frighten the person and reassure them that no harm is intended.
- Recognize that a person's delusional experience is real to them.
- When possible, announce actions before initiating them.
- Gather information from family, friends, bystanders, and the person's doctor when available.
- Request a backup officer.
- Do not threaten the individual with arrest or in any other manner as this will create additional fright, stress, and potential aggression.
When possible, officers should NOT:
- Move suddenly, give rapid orders, or shout.
- Force the discussion.
- Maintain direct, continuous eye contact with the person.
- Touch the person (unless essential to safety).
- Crowd the person or move into his or her zone of comfort.
- Express anger, impatience, or irritation.
- Assume that a person who does not respond cannot hear.
- Use inflammatory language, such as "crazy," "psycho," or "mental," within hearing range of the subject.
- Challenge any delusional or hallucinatory statements.
- Mislead the person to believe that officers on the scene think or feel the way the person does.
Statistics demonstrate that dealing with people who suffer from some type of mental illness is not going away. Dealing with EDPs has come back to the forefront of law enforcement thought because of negative outcomes and the subsequent increase in media attention. Agencies must take a proactive stance on this topic or suffer the consequences.
If an agency fails to provide the necessary policy and procedure, guidance, and training, officers are left to find answers for themselves. It's best if officers become their own advocates and seek training, guidance, and policy reviews within their own agency. Don't let an EDP's bad day become your worst nightmare.
Amaury Murgado retired a senior lieutenant from the Osceola County (FL) Sheriff's Office with over 29 years of experience. He also retired from the Army Reserve as a master sergeant. He holds a Master of Political Science degree from the University of Central Florida.