Crisis Intervention and CIT in Corrections
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BY LT. J. HENLEY
Crisis Intervention
Lesson Goals
Describe process to refer Inmates to mental health
services (As a class)
State the 2 primary reasons for CIT
Complete 1 graded scenario (Individually)
Frontline PBS special
History of CIT
Police response…person with a
knife…Memphis, TN, 1987
Joseph Dwayne Robinson, 27
Known “frequent flier” (High use caller)
Mental health history
Imminent threat
Escalating tensions…ignoring directives…threatening officers…
The Aftermath
A known cutter and schizophrenic
History of psychiatric hospitalizations
Robinson was African American
Officers were Caucasian
Cutting himself and threatening officers
Lethal response to legitimate threats
Community outrage…
Could we have done more?
CIT in Prisons
CIT is for street cops why do we care?
While CIT was originally developed to increase safety for
Officers and those afflicted with mental illness in the
community….why not use CIT principals to increase safety
within the prison system.
The Nature of Crisis
What exactly is a crisis?:
An emotionally significant event or radical change of status in
a person’s life.
Example:
Family Death
Divorce
Financial troubles
Anything
Symptoms of a Crisis
Persons suffering a crisis may show physical
symptoms Ex.
Appearing very upset or angry
Is crying
Seems very confused and/or disoriented
Is withdrawn; is not interacting with or responding to other
people
Acts depressed
Seems to be out of touch with reality
Stages of Crisis
1. Normal State: there is no crisis yet. The individual is at
their baseline.
2. Stimulation: something happens to cause the person to
become excited, upset, active or physically uncomfortable.
3. Crisis state: The person becomes temporarily out of control.
They may scream yell, stamp feet.
4. De-Escalation: in this phase, there is gradual decrease in
the crisis behaviors.
5. Stabilization (return to baseline)
6. Post-Crisis Drain or Depletion: Typically, a person in this
stage is quiet, tired and/or withdrawn and may express some
regret about his/her actions, including crying.
Responding to those in crisis
In responding to people in crisis, never assume that a
person ought or ought not to feel as he or she does in
a given situation.
Crisis is a matter of a person’s perceptions.
For example:
An inmate appears to be having an emotional breakdown over
something seemingly trivial…..what do you do?
Officer Safety
Tactical considerations
To accomplish these goals, you will possibly need to apply the
concepts and skills you will learn from your department’s
Arrest and Control Techniques training. This is very
important because when you are dealing with any emotionally
disturbed person (EDP), you are going to be dealing with
someone who is
potentially dangerous
, at least for a short
period of time. The person may be angry, upset, even out-of-
control, and may not be thinking clearly or rationally. Some
EDP’s may have a mental disorder. Certainly, most people
with mental illness are not violent or dangerous, but some
are—particularly when they are under the influence of alcohol
or drugs.
Officer Safety
Signs
Conspicuously ignores you
Gives you excessive emotional attention
Moves in an exaggerated way
Ceases all movement
Has a known violent history
Specific pre-attack postures include:
Boxer stance
Hand set/clenched fists
Shoulder shift
Target glance
The “thousand-yard” stare
Crisis Intervention Techniques
VIDEO OF DROP THE KNIFE DROP THE KNIFE
type incident here
Crisis Intervention Techniques
Calm yourself
Speak calmly, being assertive is fine but your goal is to
de-escalate the situation
Center yourself and get focused
Focus on the situation at hand.
Develop a strategy for the intervention
Have a plan, what is the goal post de-escalation?
The Talk
Try to get the person’s attention.
This is an important first step. You will not be able to make
progress with a person in crisis unless he or she is paying
adequate attention to you. Keep in mind that a person in
crisis is more likely to see you rather than to hear you, at
least initially.
The Talk
Check on the person’s perception of reality.
A person in crisis may or may not perceive reality
accurately. This may be particularly true of someone who is
experiencing a mental disorder, but may also be true of a
person who is under the influence of alcohol and/or drugs,
or is in a temporary crisis for any reason.
The Talk
Try to establish rapport with the person.
To try to alleviate the person’s fears and to get him or her to
trust you, there are certain things that you can and should say
to a person in crisis.
The Talk
Explain Your Perception of Reality
At the same time that it is important for you to try to
understand the perception of reality of a person in crisis, it is
also important for you to try to make clear your perception of
reality to that person. This helps the other person to
distinguish between what he or she is experiencing and what
you are experiencing. Some people in a crisis—whether based
on mental disorder, alcohol or drug abuse, etc.—are uncertain
as to what is “real” or not.
The Talk
Move toward Resolution of the Situation
Finally, you need to try to move toward achieving a resolution
of the situation. What that resolution is depends on the reason
that you are there. You may have resolved the immediate
crisis, and nothing more needs to be done. Or resolving the
crisis may be just the initial step, and something else must
follow—such as taking the person to the infirmary, to the unit
psychologist or placing them in segregation.
AVOID THE FOLLOWING
Avoid anything that may unnecessarily escalate the
situation, such as:
Being overly authoritative if you do not have to do so
Talking too loud or too fast, so as to frighten or confuse
the subject
Pointing at the person with the “parental finger”
Laughing at the person or using derogatory words or
phrases. DO NOT CALL THEM CRAZY
Take your time—don’t rush the encounter.
ETC………..
Conclusion
In short, a person can be “emotionally disturbed”—going
through a crisis period—for any of a number of reasons.
When you are dealing with an EDP, of course, you may not
know what caused the crisis and you may not know which
category the person falls into. For example, when you respond
to a call about a person creating a disturbance, you probably
wouldn’t know whether the person is mentally ill, under the
influence of alcohol, or is just upset about some life situation.
Fortunately, you don’t need to know the reason for a crisis in
order to respond to it effectively. Your job is to intervene and
manage the crisis situation as best you can, not to diagnose a
person’s problem or to provide therapy. While in some cases it
might be helpful or useful for you to know the reason behind
the crisis, you will apply the same basic crisis management
skills.
Scenarios
1.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC37
69782/
http://www.citinternational.org/
http://cit.memphis.edu/
http://cit.memphis.edu/pdf/CoreElements.pdf
Explore the concept of crisis intervention, the history of Crisis Intervention Teams (CIT), and the application of CIT principles in prison settings. Learn about the nature of crises, symptoms, and stages, with a focus on referring inmates to mental health services and enhancing safety within correctional facilities.
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Presentation Transcript
Crisis Intervention BY LT. J. HENLEY
Lesson Goals Describe process to refer Inmates to mental health services (As a class) State the 2 primary reasons for CIT Complete 1 graded scenario (Individually)
History of CIT Police response person with a knife Memphis, TN, 1987 Joseph Dwayne Robinson, 27 Known frequent flier (High use caller) Mental health history Imminent threat Escalating tensions ignoring directives threatening officers
The Aftermath A known cutter and schizophrenic History of psychiatric hospitalizations Robinson was African American Officers were Caucasian Cutting himself and threatening officers Lethal response to legitimate threats Community outrage Could we have done more?
CIT in Prisons CIT is for street cops why do we care? While CIT was originally developed to increase safety for Officers and those afflicted with mental illness in the community .why not use CIT principals to increase safety within the prison system.
The Nature of Crisis What exactly is a crisis?: An emotionally significant event or radical change of status in a person s life. Example: Family Death Divorce Financial troubles Anything
Symptoms of a Crisis Persons suffering a crisis may show physical symptoms Ex. Appearing very upset or angry Is crying Seems very confused and/or disoriented Is withdrawn; is not interacting with or responding to other people Acts depressed Seems to be out of touch with reality
Stages of Crisis 1. Normal State: there is no crisis yet. The individual is at their baseline. 2. Stimulation: something happens to cause the person to become excited, upset, active or physically uncomfortable. 3. Crisis state: The person becomes temporarily out of control. They may scream yell, stamp feet. 4. De-Escalation: in this phase, there is gradual decrease in the crisis behaviors. 5. Stabilization (return to baseline) 6. Post-Crisis Drain or Depletion: Typically, a person in this stage is quiet, tired and/or withdrawn and may express some regret about his/her actions, including crying.
Responding to those in crisis In responding to people in crisis, never assume that a person ought or ought not to feel as he or she does in a given situation. Crisis is a matter of a person s perceptions. For example: An inmate appears to be having an emotional breakdown over something seemingly trivial ..what do you do?
Officer Safety Tactical considerations To accomplish these goals, you will possibly need to apply the concepts and skills you will learn from your department s Arrest and Control Techniques training. This is very important because when you are dealing with any emotionally disturbed person (EDP), you are going to be dealing with someone who is potentially dangerous, at least for a short period of time. The person may be angry, upset, even out-of- control, and may not be thinking clearly or rationally. Some EDP s may have a mental disorder. Certainly, most people with mental illness are not violent or dangerous, but some are particularly when they are under the influence of alcohol or drugs.
Officer Safety Signs Conspicuously ignores you Gives you excessive emotional attention Moves in an exaggerated way Ceases all movement Has a known violent history Specific pre-attack postures include: Boxer stance Hand set/clenched fists Shoulder shift Target glance The thousand-yard stare
Crisis Intervention Techniques VIDEO OF DROP THE KNIFE DROP THE KNIFE type incident here
Crisis Intervention Techniques Calm yourself Speak calmly, being assertive is fine but your goal is to de-escalate the situation Center yourself and get focused Focus on the situation at hand. Develop a strategy for the intervention Have a plan, what is the goal post de-escalation?
The Talk Try to get the person s attention. This is an important first step. You will not be able to make progress with a person in crisis unless he or she is paying adequate attention to you. Keep in mind that a person in crisis is more likely to see you rather than to hear you, at least initially.
The Talk Check on the person s perception of reality. A person in crisis may or may not perceive reality accurately. This may be particularly true of someone who is experiencing a mental disorder, but may also be true of a person who is under the influence of alcohol and/or drugs, or is in a temporary crisis for any reason.
The Talk Try to establish rapport with the person. To try to alleviate the person s fears and to get him or her to trust you, there are certain things that you can and should say to a person in crisis.
The Talk Explain Your Perception of Reality At the same time that it is important for you to try to understand the perception of reality of a person in crisis, it is also important for you to try to make clear your perception of reality to that person. This helps the other person to distinguish between what he or she is experiencing and what you are experiencing. Some people in a crisis whether based on mental disorder, alcohol or drug abuse, etc. are uncertain as to what is real or not.
The Talk Move toward Resolution of the Situation Finally, you need to try to move toward achieving a resolution of the situation. What that resolution is depends on the reason that you are there. You may have resolved the immediate crisis, and nothing more needs to be done. Or resolving the crisis may be just the initial step, and something else must follow such as taking the person to the infirmary, to the unit psychologist or placing them in segregation.
AVOID THE FOLLOWING Avoid anything that may unnecessarily escalate the situation, such as: Being overly authoritative if you do not have to do so Talking too loud or too fast, so as to frighten or confuse the subject Pointing at the person with the parental finger Laughing at the person or using derogatory words or phrases. DO NOT CALL THEM CRAZY Take your time don t rush the encounter. ETC ..
Conclusion In short, a person can be emotionally disturbed going through a crisis period for any of a number of reasons. When you are dealing with an EDP, of course, you may not know what caused the crisis and you may not know which category the person falls into. For example, when you respond to a call about a person creating a disturbance, you probably wouldn t know whether the person is mentally ill, under the influence of alcohol, or is just upset about some life situation. Fortunately, you don t need to know the reason for a crisis in order to respond to it effectively. Your job is to intervene and manage the crisis situation as best you can, not to diagnose a person s problem or to provide therapy. While in some cases it might be helpful or useful for you to know the reason behind the crisis, you will apply the same basic crisis management skills.
Scenarios 1.
References https://www.ncbi.nlm.nih.gov/pmc/articles/PMC37 69782/ http://www.citinternational.org/ http://cit.memphis.edu/ http://cit.memphis.edu/pdf/CoreElements.pdf
