PIIMIC

Police Intervention - Overview

General police procedures
Try to establish rational communication. Use patience and develop trust to find and build on the subject's ability to communicate. Police should be friendly or at least polite, speak slowly and use short, simple sentences. Repetition may be necessary. It is best for one designated member of the intervention team to do most of the talking. Intoxicated, frightened and manipulative cases need special approaches.

Intervention tips - recommendations what to say and do
Focus on safety and manage immediate danger. Establish friendly communication. Try for sit-down conversation. Manage subjects who are obviously at risk. Get history of illness. Get medical treatment situation. Deal with denial. Prioritize subject's rights to safety and health. Be moderate if force/restraint is needed.

Notes about ambiguous intervention situations
Off medication: symptoms may be amplified by a rebound effect from going off medication; if the behaviour is unsafe or potentially unsafe, hospitalization is the best prospect to restabilize the patient. Masking/denial - hiding symptoms: a few minutes of conversation may be helpful in directly observing any problems in speech, thought, mood or behaviour; police can take action based on their own observations or based on information received (collateral information).

First psychotic episode a first break, or repeat?
There can be some differences in behaviour during a person's first psychotic break vs. subsequent breaks. In a first break, the subject may be frightened, in denial, and afraid of medical intervention. In repeat episodes, with a known diagnosis and with a history of previous hospitalization and/or medication, an "experienced" subject may deploy coping strategies

Opening lines
Examples such as: "My name is xyz. I'm a police officer. We're here to help. What seems to be the problem?"

Control lines
Examples for uncooperative subjects: "...You need a doctor to check out your medical problems and get them under control. Would you prefer the doctor at the lockup, or the doctor at the hospital?"

Conduct of intervenors can make a positive difference

Human behaviour becomes more complex and more difficult to predict when it's a mixture of normal rationality with symptoms of a mental disorder. People in psychiatric crisis often have distorted perceptions, slow communication, and magnified fears, yet retain some rationality. The key for effective police conduct is to look for and work with that rationality, while being patient about the heavy static. When police approach, the person probably needs to feel non-threatened as well as getting offers of help. Police can encourage cooperation by treating the subject with normal respect and extra consideration: introducing themselves, speaking slowly and briefly, taking charge in a firm but friendly manner, using a moderate tone of voice.

Command, force or restraint may be unavoidable in apprehending a dangerous or violent or suicidal subject who is also psychotic. But even then, for legal and humanitarian reasons, police are in a preventive role - protecting people from harm and restoring peace. This includes protection from self-harm as well as protecting others from harm. Explain calmly what you are doing and why.

When possible, kind and considerate intervention is recommended. It can provide peace to the victim tormented by severe symptoms. It can bring peace to the subject's worried family and friends. At its best, police intervention can be a turning point into positive treatment of mental disorder - even before hospital admission.