How to Improve Collaboration: Using the right language when enlisting the help of law enforcement

1. How to Improve Collaboration: Using the right language when enlisting the help of law enforcement Jeanie Paradise, M.A., LPC The Center for Health Care Services International CIT Conference Vegas 2012 Reference: Texas Commission on Law Enforcement Officer Standards and Education (TCLEOSE)

2. Every situation is different so these tips may not resolve your current situation every time but may help you build a more collaborative relationship with your law enforcement agency and in time improve your outcomes.

3. Elements of Texas Jail DiversionH.B. 2292 TCLEOSE Educate law enforcement personnel and the courts Develop the following: Crisis Intervention Training (CIT) A centralized location for mental health assessments in lieu of arrest for individuals with non-violent criminal conduct Holding facilities providing structured treatment in lieu of arrest Linking and referral services Timely and effective screening process

4. Elements of Texas Jail DiversionH.B. 2292 • Required community support • An identified method for addressing housing and needed support services • Pre-booking diversion occurs at first contact with law enforcement, • Prior to any formal charges • CIT and Crisis Center • Post booking divert consumers after they have been booked. A plan is then created for implementation upon consumer’s release from jail.

5. People with mental illness who commit crimes with criminal intent, unrelated to symptoms of mental illness should be held accountable for their actions as would anyone else. People with MI should not be arrested because of their mental disorder They should not be detained in jails or prisons longer than others because of their illness. TCLEOSE

6. Jail Diversion Concepts Facts: TCLEOSE Calls for police services in which mental illness is a factor make up between 7% and 10% of all police contacts and continue to pose significant operational problems for the police National analyses has demonstrated that diverted clients have significantly lower criminal justice costs than non-diverted clients.

7. Jail Diversion Benefits: TCLEOSE Decriminalization of persons with mental illness The problem of over representation of people with mental illness in the criminal justice system is addressed Reduced hospitalization Increased public safety Length of stay in jails shortened in lieu of increased access to treatment Violence and victimization is reduced Costs incurred by taxpayers when a person with a mental illness is arrested, incarcerated, and/or hospitalized are addressed.

8. Law Enforcement Mental Health TCLEOSE Works With: Perpetrators, Defendants Patients, Clients or Consumers and Offenders Institutions: Jails and Prisons: Hospitals: pressure to reduce utilization and rely on community resources Emphasis: Public Safety Least Restrictive Alternative Deals with…. Behavior Illness Uses… Authoritarian and Adversarial Team Approach, not sure who is Charge Deals with… Recidivism where common and Chronic illnesses where relapse is not expected common Views…. Mental Health Individuals as Law Enforcement individuals as odd autocratic

9. Cont. Law Enforcement Mental Health TCLEOSE Views… Mental Health as fuzzy thinkers, Law Enforcement as world of too process oriented and takes rigid thinkers, make decisions too long to reach a conclusion. too quickly, see everything in Everything gray. Black and white, fail to appreciate debilitating nature of MI. Both look at Chaotic and impossible to Chaotic and impossible to Others worlds understand indecipherable understand and indecipherable As……….. Jargon used to confuse other. jargon used to confuse the other. Feels……. Not appreciated for the pressure Unappreciated for pressure it is they are under to deal with the under to care for endless endless stream of perpetrators, stream of patients it is asked defendants and victims. To serve.

10. Biases These biases interfere with working together. But do we have more in common then we think? Both care about the people we serve want to live more productive and happier lives to protect the world fear the newspaper headlines involving one of their “customers”. TCLEOSE

11. It has been long recognized that Law Enforcement collaborative agreements with Mental Health agencies is the key approach in dealing with the national Mental Health service crisis. There is a direct link between inadequate mental health services and the growing number of mentally ill who are incarcerated…CJ/MH consensus project

12. First step to successful collaboration: Desire to work together on solutions. TCLEOSE

14. Collaboration: Time Commitment Risk Perhaps the most difficult challenge is a willingness to give up some degree of control to allow for real collaboration. TCLEOSE

15. Re-enactment Training Video

16. Strategic Helpful Tip: Ultimate goal: serving the individual! Put the person’s needs before your own.

17. Once you have offended an officer how likely is he/she going to help? Set your own ego aside Ask for the Officer’s help Avoid telling an officer what to do Avoid talking down to an officer Avoid using your credentials as a means to make them agree It’s best to use the art of suggestion

18. Helpful Tip: Always get the Officer’s name and badge number at the beginning of the conversation rather than after you’ve disagreed with him or her.

19. What happens after you’ve argued and then ask for his/her name? • This usually implies that you intend to file a grievance or complain on the officer • Problem with starting off that way is this is the Officer’s assigned district and he/she will be the person you will need to call on for future assistance • Developing a working relationship early on is what is most helpful

20. Helpful Tips: Avoid buzz words that have a different meaning for law enforcement. “Transport” is usually referred to in a court order for transportation which in our county is done by the Sheriff’s Office. If you feel it is unsafe for the consumer to drive himself/herself to the hospital, or for you to drive them, state the reasons clearly. Keep the focus on SAFETY

21. Helpful Tips: Give the officer the opportunity to interview the individual, doctor or other credible source if he/she feels it is necessary In Texas, an officer can use a credible source to obtain the information necessary for an Emergency Detention If you are the credible source, you can not remain anonymous Often the officer prefers to speak to the consumer directly Unless unsafe, you should allow this to occur

22. Example: 1. Thank the Officer for coming Suggested: “Thank you so much for coming out here Officer, I could really use your help.” Discouraged: “Gosh we’ve been waiting over 2 hours, thank God you finally got here!”

23. Helpful Tips: 2. Introduce yourself and your role Suggested: “Hi my name is Jeanie Paradise. I’m the administrator in charge for the unit and this is Sally. What was your name officer? And can I please get your badge number for my records?” Discouraged: “You need to do an emergency detention on her and transport her to the hospital it’s 5:00 and we are about to close the clinic.”

24. Example: Explain the situation and how you need his/her help. Be factual, concise and honest. Stay focused on the individual’s needs and acuity not who’s right or who’s wrong. Suggested: “I’m hoping you’ll consider an Emergency Detention for Sally as I believe she is a danger to herself. She came in today and told me she wanted to kill herself. She said she would go home and take all of her medication which she has stored up for several months. Yesterday, her husband filed for divorce. I’m worried about her safety and she does not want to go to the hospital.”

25. Example: Suggested: “I’ve contacted the private hospital who has agreed to evaluate the consumer. I’m just really concerned that she will not make it there. I’m worried she will wreck her car since she is so upset. I don’t believe it is safe for me to drive her since I’m worried she will try and jump out of the car or that she will change her mind once we get there and not sign in.” Again, focus on acuity and the consumer’s needs.

26. Hesitant Officer? Sometimes despite what you believe clinically, the officer does not see for him/herself. In Texas, only a licensed peace officer or a Magistrate Judge can issue an Emergency Detention but they can use you as a credible source if they do not see the behavior themselves. Ask the officer to consider using you as the credible source for his emergency detention. Ask politely for the officer to consider consulting with their supervisor .

27. Asking for a supervisor Suggested: “Would you consider contacting your supervisor on this to get his/her opinion on what we should do because I know I’m going to have to contact my supervisor? I’m just concerned about the consumer’s safety.” This is not the time to threaten to report the officer. There is still time to use your negotiation skills.

28. If you still disagree Try asking to speak to the officer’s supervisor yourself. Tread lightly and continue to negotiate. Stay focused on the individual’s safety (acuity symptoms) and not your own needs, (such as the office is closing in 5 minutes, or your own ego). Document the outcome with the officer well. Inform the officer that you may need to call the officer back or call the dispatch office back for further assistance. Professionally inform the officer and his supervisor that you will be documenting the outcome and that it did not support your clinical recommendation.

29. 573.001. APPREHENSION BY PEACE OFFICER WITHOUT WARRANT. • has reason to believe and does believe that: (A) the person is mentally ill; and (B) because of that mental illness there is a substantial risk of serious harm to the person or to others unless the person is immediately restrained; and (2) believes that there is not sufficient time to obtain a warrant before taking the person into custody. (b) A substantial risk of serious harm to the person or others under Subsection (a)(1)(B) may be demonstrated by: (1) the person's behavior; or (2) evidence of severe emotional distress and deterioration in the person's mental condition to the extent that the person cannot remain at liberty. (c) The peace officer may form the belief that the person meets the criteria for apprehension: (1) from a representation of a credible person; or (2) on the basis of the conduct of the apprehended person or the circumstances under which the apprehended person is found. (d) A peace officer who takes a person into custody under Subsection (a) shall immediately transport the apprehended person to: (1) the nearest appropriate inpatient mental health facility; or (2) a mental health facility deemed suitable by the local mental health authority, if an appropriate inpatient mental health facility is not available. (e) A jail or similar detention facility may not be deemed suitable except in an extreme emergency. (f) A person detained in a jail or a nonmedical facility shall be kept separate from any person who is charged with or convicted of a crime.

30. Contact Information • Jeanie Paradise • jparadise@chcsbc.org • 210-225-5481