Month: April 2016

Police Officer’s Dilemma, Encounters with the Mentally Ill

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Police Officer

Police throughout the nation have intensive training before becoming officers. That is as it should be for such a complicated job. What is not very well known is most locals only provide 4 hours of training on encountering the mentally ill.

Mental Illness is such a complex human condition that psychiatrist go three additional years after medical school. The lack of baseline training provided regarding mental illness, is a very discouraging fact, and an unfair allocation of training priorities to police officers. An encounter with a symptomatic person is a challenge with most times a good result. These situations can also get out of control in an instant resulting in outcomes such as arrests, beatings and sometimes death.  Prior to 1988 the norm was for the family and advocates to get outraged, the press to focus on the incident, and then with the passage of time it would fade away, until the next negative encounter.

Fortunately, in 1988 the Memphis Police Department had the foresight to develop at Crisis Invention Training (CIT) that included 40 hours with the goal of creating a jail diversion prior to arrest.  Finally, a police officer who was under trained had a professional focus 40-hour quality training.

Adoption of CIT training across the country has been steady, but not ubiquitous. Being trained in CIT doesn’t guarantee the prevention of a negative outcome, but it does increase the chances of a positive outcome. Studies have shown CIT to be effective.  The infrastructure supporting CIT has grown more professional each year. The future gets better as more CIT officers will be encountering these precarious situations.

Jail diversion and treatment is essential. An act of advocacy for those reading this article is to contact your local NAMI.org affiliate and inquire if the local police department has CIT training. If not, or if the percentage of officers trained is not 100% then ask how you can help. Contact your board of supervisors.

There have been so many recent news stories that have come to the conclusion that the criminal justice system has become the country’s answer to dealing with mental health that it is now common knowledge.  CIT training is one piece of the solution puzzle for assisting this vulnerable population.

While many have claimed that the criminal justice system is the countries answer to mental health at this point, author German Lopez recently published an article examining the true ramifications of the claim. In the article, “How America’s Criminal Justice System Became the Country’s Mental Health System,” Lopez examines several cases where police officers have responded to deal with scenarios of mental illness.

Officers respond to calls involving people who face both diagnosed and undiagnosed mental illnesses every day. It is important to remember what a police officer’s job is when they respond to such a call. When an officer arrives on scene, it is their job to uphold the law, and keep all citizens including themselves safe. Officers do go through extensive training to learn how to make these quick decisions, and what the best case scenario is. At the same time, the basic education they receive does not necessarily pertain to symptomatic mental illness.

When faced with someone who has decompensated and is in a state of complete mental breakdown, there is an immediate need for the officer to regain control to ensure that the person does not hurt themselves or anyone around them. In Lopez’s article, this critical moment in the decision making process is where one of two things occurs, either: “officers blasted him twice with a Taser, shocking him with 50,000 volts of electricity each time,” or “A police officer with training for mental health crisis, approached Kevin…this officer talked softly, reasoned with him, and finally, convinced him to get into the car-no violence necessary.” (vox.com.)  Kevin is the same vulnerable person facing mental illness that went through both of these traumatic experiences.

The first experience of being tased, should not be the norm.  It is the product of a cop making what they considered to be the best decision to regain control. Having a trained officer who responds to the situation with their voice rather than physical action, will go much further in that person’s recovery. Providing officers with education gives them knowledge about various illnesses, and how they may be evident in people’s behavior, as well as the best methods for making quick decisions on how to handle the situation. The proof of how well education works lies in the outcomes.

For Kevin, the person who went through both of the above encounters, it was because of the second officer’s communication and decision to take Kevin to the hospital that he was able to get help. He was able to fight the charges against him at the time, and best of all, “With proper care and medication, Kevin has not had a dangerous run-in with police in nearly 10 years since.” (vox.com) That right there speaks for itself. Kevin has been able to remain in control of himself through care and medication, and has not gotten violent to require police intervention in a decade.

There are thousands of Kevin’s out there, thousands of people who wind up in jail because of the disease they struggle with. These are people who courts deem unfit to stand trial, yet there is nowhere for them to go and not enough education out there to help police officers as they respond to the same call for the same person over and over again.

When a mentally ill person does commit crime, they are responsible.  The solution is treatment before trouble. Through education, programs such as CIT, and the modern therapeutic treatment model, it is possible to allow police officers to do their job more effectively.  By giving them knowledge of how to react to someone who is facing a mental illness, and providing them with tools and supports for where to take the person to get the best help, it is possible to reduce the chances of an immediate repeat situation and ultimately hopefully keep that person from entering the cycle of being in and out of jail.

Homelessness: Beyond a Matter of Choice

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Homelesness Graphic
Image Courtesy of: Serge Bertasius Photography, at freedigitalphotos.net

 

Why would someone choose to be homeless?

There is no one answer to this question. Each person you ask would see their world a little bit differently and give a unique response. The plethora of answers include but are not limited to: drugs, laziness, learned helplessness, victimization, and economic hardship. For many, being homeless is not a matter of choice, but rather a fact of life.

According to the Substance Abuse and Mental Health Services Administration, 20 to 25% of the homeless population in the United States suffers from some form of severe mental illness (SMI). In comparison, only 6% of Americans are severely mentally ill (National Institute of Mental Health, 2009).

Upon researching different forms of SMI, one will quickly discover that most have one thing in common; they impair a person’s ability to complete their basic daily functions.  Gainful employment is often impaired by symptoms, and although some will receive disability benefits; others may fall through the cracks and not know about disability or be too symptomatic to apply. If one cannot complete the basic daily functions such as showering or remembering to eat three meals, how are they supposed to have self-awareness to go out and get access to the programs and services designed to help them survive? Without these programs they lack the basic necessities of a roof over their head, food in their mouths, and reliable medical care.

Food in the life of a homeless person comes from wherever it is available. More important than where the food comes from is what, if any nutritional value. In a society rampant with easy access to junk food, unhealthy foods are much more prominent. Chronic hunger results in getting food to fulfill the need as fast as possible, regardless of what it is. The nutrients that food provides to the brain are key in a chemically balanced person, and critical in a chemically imbalanced person.

If someone cannot regularly access healthy food, they likely don’t receive necessary medical attention or have a reliable place to store their prescribed medications so critical for treatment. Without storage, they are exposed to thieves who take the medication, expiration of the medication when it is not kept in the proper climate, the appeal of selling their medication to have money, or the desire to not take the medication because of the side effects or not believing they have an illness, called anasognosia. All of these realities disturb the normal routine that is fundamental for the medication to be effective. Now, you have an equation of food as an irregular resource that is key for survival, medication that is ineffective without regular dosage, and perhaps most importantly nowhere to rest at night. Irregular sleep is unhealthy and can be a trigger for many symptoms.

Without a secure place to live, homeless must sleep wherever they can. This may include but is not limited to, a local abandoned business building, a park bench, or a local homeless camp. All of these have one thing in common, they are temporary. It is only a matter of time before the public outcry forces police to do something about these types of places. Remember the mental stability piece of the equation as police repeatedly go to these “camps” and warn people that they will be forced to clear the area on a certain date. The likelihood of a. remembering the date, or b. cognitively recognizing what the warning actually means, is little to none. When the day comes that they are kicked out, the question becomes where to go next. The underlying problem is that the cycle is merely starting over, there is no resolution. Sure, one area is clear, but another will quickly pop up as the next makeshift home.

Is there a way to “fix” homelessness?

Although there is not one simple fix, there is a viable starting place. Enter the idea of therapeutic treatment that is based on lasting recovery, rather than temporarily assisting someone to reach a level of stability while still on the street.  If one goes from homelessness to entering a care facility, with access to the right tools to treat their diagnosis and teach them how to live with their diagnosis and complete daily tasks they are capable of, then you have a recipe for success.

Providing a systematic way out of homelessness has proven to be very successful.  The idea of housing first, or getting someone into a stable place to live right away, and then helping them to get other resources such as access to medical care allows for a better chance at getting back on your feet for the long term; rather than being placed in a temporary situation with a high risk that things will go back to the way they were, resulting in being homeless once again.  Often times, a transitional residential program is one of the first steps to teaching life skills to help a person on to a path of recovery and individualized level of achievement for everlasting change, that may very well prevent them from being homeless again.

 

Alano Club Modesto Event

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One of the greatest assets an individual can have in their journey through life is community. A sense of communion or belonging amongst one’s peers allows for simultaneous comfort and growth; as an individual finds their sense of self and develops the realization that they are not alone in the world. Often times, a community of people is based around similar interest or experiences. Having the relatable experiences be positive is a great thing, although it is when the experiences are negative that relatability becomes critical. Whether it be out of fear, embarrassment, or a range of other emotions, people don’t often want to come right out and talk about negative experiences. Having others who have gone through something similar allows one to see not only tangibly see success within other people’s lives, but also to subconsciously start to envision themselves adapting to those same successes in their life.

Two types of experiences specifically related to Ever Well Health Integrated Health Care are substance use issues, and mental illness. There is something to be said for pure relatability amongst people who have shared similar experiences in both of these areas. It is in places such as modern therapeutic treatment communities and Alano clubs that healing and growth are provided within a community setting.

The Alano Club of Modesto has been providing a place for people to go and commune for more than 40 years. In this month’s Stanislaus Magazine, John Black, of the Peer Arts Recovery Project says: “The Club’s managers believe in maintaining its roots as a haven for those who need it as well as a gathering spot for those who want to remain sober and enjoy some great company.” (page 43). All of these gatherings are organized through the efforts of wonderful volunteers. While the club does have a small membership fee, they rely for the majority on donations and fundraisers to be able to cover basic expenses and keep their doors open.

Ever Well is proud to partner with the Peer Art Recovery Project, to host a benefit for the Alano Club of Modesto. The April 16th event aims to provide a night of socializing for community members, while raising funds for a great cause.

What is the relationship between the Alano Club as a sober environment to someone who faces a mental illness?

There is typically a large connection between mental illness and substance abuse as people facing these issues fall on hard times and turn to a variety of sources for escape and comfort. This reaction is not always the case, although it is always the case that places like the Alano Club that allow for people to thrive. Just like kids like to join sports teams with their friends, or adults join things such as book clubs, people who face mental illness, or have substance use issues alike need a place to convene to socialize and celebrate their accomplishments. The Alano club offers this space with people who have had similar experiences in their lives. As John mentions in his article, people who previously turned to alcohol or drugs to escape or celebrate, now have a way to celebrate their accomplishments in a safe, sober place.

As people spend time at Ever Well getting the tools they need to build a stable life, it is important for their program activities to include introductions to places such as wellness centers and Alano clubs so that wherever that person may end up, they will know how to reach out to develop a community to be continually reminded that they are not alone. The sense of belonging and comfort astronomically improves one’s chances of staying on a clean stable path to have a great life. We at Ever Well value the opportunity to support an organizations like the Modesto Alano Club and The Peer Arts Recovery Project to ensure the gift of community and sobriety for many years to come.

If you or someone you know is facing a mental illness or substance use issue in Central California, please contact the Peer & Family Advocate at: (209) 543-2425

To support recovery efforts in the Central Valley click here.

 

 

 

 

 

Siri Doesn’t Have an Answer

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Original Article: http://www.independent.co.uk/life-style/gadgets-and-tech/news/siri-physical-mental-problems-health-voice-assistants-a6932891.html

 

A recent study conducted in partnership by Stanford University, and The University of California found that while smartphone voice assistants have become very popular, they are rather inadequate when it comes to offering help to people in crisis. During the study, several statements were said to the various smartphone platform voices, and very little useful information was repeated back by the voices. To better demonstrate, the article states, “In fact, very few of the services could help distressed users apart from in cases of suicide or physical injury- Siri directs users to the emergency services or nearby health centers if it detects they’re reporting health problems, but it can’t differentiate between ‘I’m having a heart attack’ and ‘my foot hurts’.” This is problem when considering the article’s mentioned statistic that 62% of Americans refer to their cellphones for information regarding health.

If these voice response systems have the capability to quickly search databases yet can’t return an answer to the consumer, imagine the time a family member could spend searching the databases themselves while still not getting any answers. Without experiencing the symptoms for themselves, a family member approaching the topic for the first time is probably going to find their research to be about as informative as Siri’s answer. The incapability of a smartphone voice’s response regarding topics such as mental illness, indicates not only a problem with the technology per say, but also an example of how the resources within the online community can be muddled. In a situation where the spectrum of symptoms is as wide as the multitude of diagnosis, getting on the right path towards help is not easy. Whether it be the individual facing the illness themselves, or family and friends seeking help, the abundance of resources can prove to both help and hinder the process.

If you or a family member needs help, please call the national mental health association: 1-800-969-6642.