Mental Health Peace Officer Course # 4001

1. Mental Health Peace Officer Course # 4001 Texas Commission on Law Enforcement Officer Standards and Education

2. Unit Goal: 1.0. To sensitize officer to the adversity of mental illness. • 2004 U.S. Census • 26.2% had a diagnosable mental disorder • 6% serious mental illness • 45% two or more • Leading cause of disabilities in ages 15-44

4. Factors affecting mental health situation • Deinstitutionalization • Criminalization • Medicalization • Privatization

5. 1.1.Define the term “mental illness.” • Illness, disease, or condition that either substantially impacts a person’s thought, perception of reality, emotional process, or judgment, or grossly impairs a person’s behavior, as manifested by recent disturbance behavior.

6. 1.2. List three categories of mental illness most predominately identified with disease severity • Psychotic Disorder: All cases of schizophrenia • Mood Disorder: Severe cases of major depression and bipolar disorder • Anxiety Disorder: Severe cases of generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder

7. Cognitive Disorders (Alzheimer’s, Substance Abuse) • Personality Disorders (Paranoid, anti-social) • Disorders first diagnosed in infancy, childhood or adolescence (Autism, Mental Retardation, Attention Deficit Hyperactivity Disorder)

8. 1.3. Define terms associated with a Psychotic Disorder • “A group of serious and often debilitating mental disorders...are characterized by...impaired thinking and reasoning ability, perceptual distortions, inappropriate emotional responses, inappropriate affect, regressive behavior, reduced impulse control and impaired reasoning of reality.” (Social Work Dictionary, 2nd Edition, by Robert L. Baker)

9. Definition of Delusion • False beliefs not based on factual information. A delusion implies belief in something that is contrary to fact or reality, resulting from deception, a misconception, or a mental disorder. A persistent belief maintained in spite of evidence to the contrary.

10. Definition of Hallucinations: • Distortions in the senses where the individual experiences auditory sounds and/or visual images that are technically not there.

11. 1.3.1. Discuss Schizophrenia and its relationship with Psychotic Disorders • Schizophrenia consists of a group of psychotic disorders characterized by changes in perception.

12. 1.4. Discuss the characteristics of a Mood Disorders • A mood disorder is a mental health disorder with an abnormal mood as its primary feature.

13. 1.4.1. Discuss Major Depressive Disorder • A disorder that severely affects an individuals thinking and behavior. • A depressed mood or loss of interest of at least two weeks duration, accompanied by symptoms such as weight loss/gain, and difficulty concentrating.

14. 1.4.2. Identify prominent characteristics of Bipolar Disorder: • A brain disorder of a severe nature, that creates unusual shifts in a person’s mood, energy level, and ability to function.

15. Symptoms of a Manic Phase may include: • Abnormally high, expansive, or irritated mood. • Inflated self-esteem. • Decreased need for sleep. • More talkative than usual. • Flight of ideas or feeling of thoughts racing. • Excessive risk-taking.

16. The Spectrum of Bipolar Disorder: Severe Mania Hypomania (mild to moderate mania) Normal/balanced mood Mild to moderate depression Severe depression

17. 1.5. Define Anxiety Disorder • Anxiety is a normal reaction to stress. It helps a person deal with a tense situation by helping one cope. But when anxiety becomes excessive and irrational it becomes a disorder.

18. Anxiety disorders can include: • Generalized Anxiety Disorder • Obsessive-Compulsive Disorder • Post traumatic Stress Disorder (PTSD)

19. 1.5.1. Define Generalized Anxiety Disorder (GAD • Constant worries and fears that distract from day-to-day activities and leave a persistent feeling that something bad is about to happen.

20. 1.5.2. Describe Obsessive-Compulsive disorder • Distressing, unwanted nonsensical thoughts which return despite efforts to ignore them and the ritualistic behavior utilized to control these thoughts.

21. Obsessions are: • Repeated, persistent, unwanted ideas, thoughts, images or impulses that you experience involuntarily and that appear to be senseless.

22. Compulsions are: • Repetitive behaviors that an individual feels driven or compelled to perform.

23. 1.5.3. Discuss Post Traumatic Stress Disorder (PTSD) • A type of anxiety disorder that is triggered by the involvement in or witness to an extremely traumatic event.

24. DSMIV indicates: The essential features of PTSD include: “Experiencing, witnessing, or confrontation with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others”

25. 1.5.4. Apply knowledge gained to a discussion of at-risk occupations • ...persons in emergency service fields are a population highly prone to suffering from PTSD, as a direct result of their work. • ...involved in traumatic events through direct or indirect involvement on a daily basis. • PTSD affects both men and women. • ...not only with “front-line” personnel but tele-communicators, dispatchers and support staff.

26. 1.6. Discuss the term Cognitive Disorder • Cognition refers to that operation of the mind process by which we become aware of objects of thought and perception, including all aspects of perceiving, thinking, and remembering.

27. The two most common cognitive disorders include: • Alzheimer’s Disease • Substance Abuse Disorders

28. 1.6.1. Discuss the most commonly addressed organic brain disorder • The most common Organic Brain Disorder in persons over the age of 65 is Alzheimer’s disease. • Alzheimer’s is one of several disorders that cause a gradual loss of brain cells. • The cause of all demensia is abnormal loss of brain tissue.

29. . Demensia is characterized by loss of memory PLUS one or more of the following: • Aphasia • Apraxia • Agnosia • Loss of higher executive functioning

30. 1.6.2. Discuss the relevance of addressing substance abuse disorders in the topic of mental illness • Prolonged abuse of any drug can cause chemical dependency or addiction. • If these substances are used for extended periods of time/large dosages, they may also cause permanent damage to the central nervous system. • This damage can cause a wide range of psychological reactions that are classified as disorders.

31. Co-occurring Disorders • The co-occurrence of mental health disorders and substance abuse disorders, which would include alcohol and/or drug dependence or abuse.

32. 1.7. Define the term Personality Disorder • American Psychiatric Association (APA) defines as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it".

33. 1.7.1. Discuss examples of Paranoid Personality Disorder • An on-going unfounded distrust and suspiciousness of people.

34. 1.7.2. Discuss relevant characteristics of Antisocial Personality Disorder • Behavior that is manipulative. • Often victimizes and violates the rights of others. • Fail to conform to societal norms • Often have a history of juvenile conduct disorder and criminal activities prompted by reckless, impulsive and violent behaviors. • This disorder is also most common in men.

35. 1.8. List the most common mental disorders that are first diagnosed prior to the age of eighteen • Developmental disorders of Autism Spectrum Disorder (ASD), • Mental Retardation, and • Attention Deficit Hyperactivity Disorder (ADHD).

36. The Developmental Disabilities Assistance and Bill of Rights Act of 1990 defines a developmental disability as: • a severe, chronic disability of a person five years of age or older. • Such a disability is attributable to a mental or physical impairment or combination of the two. • Is manifested before a person reached the age of twenty-two. • May continue indefinitely. continued...

37. Substantial limitation of three or more specified life activities. • Reflects the person’s need for lifelong or extended care, treatment, or other services which are planned and coordinated according to that person’s needs. • Infants and young children (newborn to age 5) with developmental disabilities have substantially delayed development or specific congenital or acquired conditions

38. 1.8.1. Discuss Autism Spectrum Disorder (ASD) • Brain developmental disorder that impairs social interaction and communication; causing restricted and repetitive behavior, all starting before the age of three.

39. 1.8.2. Define Mental Retardation • A range of substantial limitations in mental functioning manifested in persons before the age of 18, creating a pattern of slow learning during childhood and significantly below normal global intellectual functioning as an adult.

40. 1.8.3. Explain the primary differences that exist between a Mental Illness and Mental Retardation • 3% of the American population is considered to posses a mental retardation (sub-average score of 69 or less on Wechler Intelligence Scale or Stanford Binet IQ test). • While…22.1% of the American population is diagnosed with a mental illness.

42. 1.8.4. Describe prevalent factors of Attention Deficit Hyperactivity Disorder (ADHD) • A medical condition characterized by difficulties with inattention or hyperactivity and impulsivity.

43. Questions and Discussion

44. 2.0. Discuss psychopharmacology as it relates to medications prescribed and prominent side effects in persons with a mental illness.

45. 2.1. Name four categories of medications utilized in controlling the symptoms of mental Illness. • Anti-psychotic • Antidepressants • Mood stabilizers (Hallucinogenic) • Anti-anxiety drugs

46. 2.2. List side effects that can be associated with utilizing psychotherapeutic medications: • muscle spasms, protruding tongue, eyes rolled back, constant leg movement, tremors, uncoordinated movements, impotence, nausea, headache, blurred vision, weight gain, fatigue, liver toxicity

47. Side effects can be • uncomfortable • dehumanizing • and are often irreversible, which may cause person to refuse to take them as directed

48. 2.3. Define Tardive Dyskinsia (TD) and its relationship to the utilization of psychotherapeutic medications • Some of these side effects are permanent, even after the medications have been stopped; the medications have a tendency to produce neurological damage.

49. 2.1.3. List common reasons for a consumer deviating from their prescribed medication schedule • Side effects • The stigma associated with being mentally ill, i.e., they don’t want people to know they have a mental illness • They start feeling better and think they no longer need the medications

50. Questions and Discussion