Imagine you are training in an immersive law enforcement simulator. The screens darken, then light up with a desert scene as the dispatch relays information on the call you are responding to. Pedestrians give you further information about the event, then point you towards a man sitting on a ledge. It becomes clear: this is a suicide call and you need to carefully persuade the man to seek help, not jump. 

This is a difficult situation, but a necessary one to train for, as any officer can be called to prevent suicide. But as important as the training topic is, the method of training is just as important. For officers who train with VirTra’s systems, the scenario will unfold based on the officer’s actions and words, creating real-life training designed to benefit both officers and their communities. Officers can train in the same scenario multiple times, trying new de-escalation tactics or certain phrases, then see how the situation plays out. Does an action cause the man to comply, lash out or jump? Which verbiage best comes into play here? Instructors watch over the trainees and, depending on the officer’s choices, they choose the applicable branch in the situation and thus create a new ending. 

Virtual Interactive Coursework Training Academy 

The simulator itself is an incredible training tool, but what about combining the classroom and the simulator? VirTra created the V-VICTA® program, which is a series of nationally-certified curriculum that is first taught in the classroom then practiced in the simulator. This all-in-one training solution instills proper training and knowledge transfer, thus helping officers remember their training in the field and utilize it to help those around them. 

For example, one V-VICTA curriculum is “Autism Awareness.” This material teaches officers how to identify possible autistic behaviors and the best ways to interact with the subject. Officers who aren’t taught how to recognize and react accordingly to these behaviors could put the subject or themselves at risk. And, according to data from the CDC, 1 in 54 children are diagnosed with autism, making it extremely likely that every field officer will interact with someone on the spectrum. To improve safety for officers and every member of their community, they must first know how to best interact with every member of the community.  

Officer training is complex, but it is always centered around safety—for subjects, bystanders, partners and oneself. To learn more about VirTra’s V-VICTA training curriculum, or to try a training simulator at an upcoming trade show, contact a VirTra specialist.

Law enforcement encounter a variety of individuals during their careers. While substance use and mental illness are discussed and trained for, there are also certain medical conditions and diseases that can affect normal communication. These conditions and diseases must also be taught to officers to prepare them to help any and every individual in their community.

For example, neurocognitive disorders (NCD’s) affect memory, understanding, task performance and much more1. The most overwhelmingly common NCD is Alzheimer’s Disease, and in the past all NCD’s were classified as dementia, when in fact there are multiple types and levels. NCD’s are typically associated with the elderly since it is most prevalent in people 65 years of age are older, but it is not exclusive to this age group.

The way NCD’s work is by causing damage to brain cells. The damage gradually makes symptoms more and more noticeable over time. Sometimes it is not immediately apparent that someone has an NCD – at times it takes a few moments for signs to appear. In general, symptoms law enforcement officers may notice and want to look out for include:

  • Memory impairment
  • Difficulty concentrating
  • Getting lost or misplacing items frequently
  • Poor judgment in decision making

Some of these symptoms do not always reflect Alzheimer’s or other similar diseases, but also traumatic brain injury or substance abuse. Law enforcement officers must also be aware that those with NCD’s have the possibility of becoming verbally or physically aggressive.

Officers can strategically communicate with those who have NCD’s by doing the following2:

  • Identify yourself
  • Speak slowly and non-threatening
  • Ask one question at a time, allowing the individual to respond
  • Repeat questions and phrases as necessary
  • Avoid confrontation

‘Neurocognitive Disorders’ is a section of VirTra’s “Mental Illness” curriculum. With a 12-page instructor guide, slideshow presentation and testing materials, law enforcement instructors can familiarize trainees with dementia and NCD’s. The coursework is designed to be used alongside simulated scenarios to allow ‘learning by doing.’

The entire “Mental Illness” set of V-VICTA® curriculum contains 15 hours of detailed coursework certified by IADLEST. To learn about how V-VICTA can be incorporated into your department’s training, contact a specialist.

 

References:

  1. Psychology Today. (2019). Neurocognitive Disorders (Mild and Major). Retrieved from https://www.psychologytoday.com/us/conditions/neurocognitive-disorders-mild-and-major
  2. Alzheimer’s Association. (2006). Safe Return, Alzheimer’s disease: Guide for Law Enforcement. Retrieved from https://www.alz.org/national/documents/SafeReturn_lawenforcement.pdf

The most recent statistics show an increase in illicit drug use. A survey in 2018 from The National Survey on Drug Use and Health published by SAMHSA shows that 1 in 5 people aged 12 or older used an illicit drug in the year prior.  “Illicit drugs” as referred to in the survey include opioids, prescription drugs, marijuana (despite its current legality in several states), cocaine and others. It is also important to note that the same survey found that substance use is more common in individuals with mental health issues than those without.

Common Factors of Substance Use

So, what exactly is substance use? It refers to recurrent use of drugs or alcohol that can cause impairment, addiction, intoxication and withdrawal. Key common factors include dependence on the substance and continued use despite problems. People addicted to a substance often spend a lot of time obtaining it and use it in greater amounts over time.

Trained professionals typically know the signs that an individual is suffering from substance use disorder. Depending on the type of drug abused and how much the subject used, signs range from slurred speech and dizziness to delusions and violence. Additionally, there is a risk of overdose and short- or long-term negative health effects. Even withdrawal symptoms experienced can be severe and lead to erratic behavior.

Integrated Intervention

A dual diagnosis refers to a person experiencing a mental illness and a substance use disorder simultaneously. A 2017 study found that 8.5 million adults suffered from both a mental illness and a substance abuse disorder simultaneously.

In the past, treatment centers treated one issue at a time, believing that the substance use needed to stop before the mental illness could be addressed. Now, newer treatment called integrated intervention treats both simultaneously.

It is important to remember that law enforcement officers should not attempt to make a diagnosis, but familiarizing oneself with the signs of both substance use and mental illness is vital to ensuring proper handling of the situation.

Simulation Training for Law Enforcement

VirTra’s Mental Illness V-VICTA™ curriculum has a module that focuses exclusively on substance use. Not only are trainees able to learn how to recognize signs of both mental illness and substance use, but are also able to practice the skills they’ve learned within the simulator.

VirTra has several scenarios including “Party Pooper” and “Misery Mountain” that correlate well with this section of the Mental Illness curriculum and expose trainees and officers alike to situations they may deal with in the real world.

To learn more about how VirTra can help law enforcement officers understand and prepare for interactions with the mentally ill and those suffering from substance use disorder, contact a VirTra specialist.

References:

Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.

Suicide by cop, often abbreviated to SBC, is an event that has two victims: the suicidal subject and the officer. These calls are incredibly difficult for everyone involved and officers must be prepared to handle any outcome. At the end of the day, law enforcement are forced with two major situations: maintaining safety and trying to de-escalate the subject.

SBC occurs when a suicidal individual engages in criminal behavior in an attempt to elicit lethal use of force from law enforcement. A 2019 article by The Washington Post estimates that about 100 fatal police shootings per year are SBC events. While occasionally some SBC subjects are armed with a firearm, many times they possess a knife or feign weapon possession.

There are different strategies used by individuals attempting SBC. Some of them plan ahead and orchestrate the situation while others occur due to a minor event that became escalated. For an integrated response, officers must take each call seriously and secure the scene appropriately. Only after can they determine the main problem and assess the risk of suicidality.

There are ways to talk a subject down and possibly prevent escalation:

  • Provide reassurance
  • Comply with reasonable requests
  • Offer realistic optimism
  • Consider non-lethal containment
  • Be careful not to let one’s guard down or be baited

While it may seem like common knowledge, it must be remembered that a person attempting SBC is suffering from a mental illness or experiencing some type of crisis. De-escalation and crisis de-escalation training can be of great assistance during SBC calls.

VirTra offers multiple scenarios as well as V-VICTA™ NCP-certified curriculum to help officers prepare for harrowing calls. These are designed by VirTra’s subject matter experts and certified by IADLEST to ensure knowledge takeaway. Some courses that focus on SBC and related situations include De-Escalation, Crisis De-Escalation and Mental Illness.

To allow your agency to experience a higher standard in training, contact a product specialist.

What officers may not realize is how incredibly common mental illnesses are within the United States. According to the National Institute of Mental Health (NIMH), nearly 1 in 5 American adults live with a mental illness. To put this in perspective, in 2019, this was approximately 51.5 million adults.

The gravity of this situation is heavy, as it guarantees officers will often interact with individuals suffering from mental illnesses throughout their career. However, do note that the severity of one’s condition will range from little/no impairment to severe impairment, meaning it will not always be noticeable.

Breaking Down Mental Illness

MIMH breaks down mental illness into two categories: Any Mental Illness (AMI) and Serious Mental Illness (SMI). AMI is defined as “a mental, behavioral, or emotional disorder” and encompasses all recognized mental illnesses. These include: depression, anxiety, dementia, PTSD, etc., ranging from little/no impairment to moderate.

As for SMI, it is defined as “mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities” and encompasses a much smaller, though more severe subset of AMI. In being more severe, it is especially important for officers to recognize various mental illnesses and know the best methods of communication. After all, the right actions can protect the life of the responding officer, the life of the subject and the well-being of the community.

Mental Illness Training Curriculum

Due to an increase in mental health awareness—and unfortunately, incidents between the mentally ill and officers which end up as headlines—VirTra created the nationally-certified V-VICTA “Mental Illness Training: A Practical Approach” curriculum. This progressive curriculum covers multiple common mental illnesses and disorders officers must be conscious of, including:

• Anxiety
• Dementia
• Depression
• PTSD
• Schizophrenia
• Substance Use
• Suicide
• Traumatic Brain Injury

While this curriculum is not meant to train officers to diagnose disorders, it instead provides tools to recognize symptoms and knowledge to deploy the correct communication techniques for the situation.

In addition to symptom awareness and recognition, implementing this curriculum in training helps officers to break stigmas, show empathy and know when/how to stage medical personnel. The mental illness curriculum consists of presentations, lesson plans and corresponding scenarios, allowing officers to learn each mental illness before engaging with it in the simulator—thus learning to correctly identify mental illnesses while building connections with various subjects on-screen.

Guided by this nationally-certified curriculum, officers increase the probability of having mental illness encounters end on a positive note. Start implementing this curriculum into your training regime by contacting a VirTra specialist.

Earlier this year, VirTra submitted and received certification on the curriculum “Mental Illness: A Practical Approach.” This curriculum covers the signs and symptoms associated with different mental illnesses as well as communication and intervention techniques. Most importantly, officers will learn how respond to the specific behaviors a person displays instead of focusing on the mental illness itself. People should be treated as individuals and not as their diagnosis.

One of the mental illnesses covered in the curriculum is Schizophrenia. Schizophrenia is a serious mental illness that affects about 1% of the national population. Schizophrenia can interfere with a person’s ability to think clearly, make decisions, manage emotions and relate to others. The severity of unmanaged schizophrenia can be extremely debilitating and disabling.

Depending on the severity of the schizophrenia, an individual may experience hallucinations or delusions. Hallucinations are false perceptions and experiences absent certain stimuli and can manifest as visual, auditory, olfactory or tactile. Delusions are false beliefs that conflict with reality. Hallucinations and delusions are common with schizophrenia, but that does not mean that person has a schizophrenia diagnosis.

A person with schizophrenia may also experience psychosis. Psychosis describes a condition where an individual has lost touch with reality, usually aligned with severe disturbances in behavior, cognitive processing and emotional regulation. The disturbance in perception makes it challenging for an individual to determine what is real and what is not. This can be especially challenging for officers.

Instead of focusing on a diagnosis, officers will learn to respond to the behaviors and clarity in thought process an person exhibits at the time of contact. This allows officers to coordinate an intervention response that is as safe and effective as possible for everyone involved. Each section of VirTra’s “Mental Illness: A Practical Approach” goes further in-depth in recognition of signs and symptoms as well as effective and safe intervention techniques.

For each curriculum, instructors are given slide presentations, booklets, pre- and post-tests, evaluation forms and simulator scenarios. This allows officers to learn the material in the classroom, then implement their new training in a real-life situation displayed in the simulator. Training in this manner ensures officers are well-rounded and skills are easily transferred to the field.

VirTra’s “Mental Illness: A Practical Approach” is part of V-VICTA, is NCP certified and meets rigorous quality training standards for the curriculum. This includes extensive research, citations, correct knowledge retention format, comprehensive testing materials and more.

Author:
Nicole Florisi started her public safety career in 1999 as a communication specialist. In 2002, she became a certified peace officer for the state of Arizona. She has been a law enforcement trainer and instructor for the past 15 years. Her areas of expertise are in crisis intervention and de-escalation, crisis negotiations, child abduction response, domestic violence, and human trafficking. She was also a Drug Recognition Expert and Instructor, Standardized Field Sobriety Test Instructor, and forensic phlebotomist. Nicole was the lead negotiator for the regional SWAT team for 12 years.

Mental Illness training is no longer important knowledge: it is crucial knowledge.

Now more than ever, officers must know how to properly recognize and interact with every member of their community. VirTra makes teaching this curriculum easy and effective by providing instructors with 15 hours of nationally-certified training material and professionally filmed simulation training scenarios.

Our Mental Illness Training: A Practical Approach curriculum includes training manuals, slide presentations, pre and post-tests, evaluations and real-life scenarios to help instructors teach the concept in the classroom, then cement the teachings by practicing the concepts in a simulator.

This training also includes interviews with individuals that have experienced mental illness and what they feel law enforcement should know from their perspective. These insightful videos are critical in helping with empathy and understanding.

Through this curriculum, officers learn to recognize a variety of mental illness symptoms—including depression, suicide, anxiety, trauma, PTSD and schizophrenia—and communicate and engage in the proper techniques for the situation.

Learn more about our Mental Illness training here.

Or watch officers engage in real Mental Illness scenarios below:

Subscribe to our YouTube channel to find other ways of maximizing training with VirTra’s curriculum.

These are difficult times to be a law enforcement officer. Already, policing is a difficult profession, more than the public realizes. No other profession requires the balance of perfect verbal de-escalation, soft and soothing mannerisms, an authoritative presence and skills to handle any person’s symptoms—all while being combat-ready and prepared for split-second moments that could be the difference between life and death.

Add these pressures to the terrible actions and events officers see and must interact with, and it is no wonder policing has a PTSD crisis.

PTSD in the Industry

Post-Traumatic Stress Disorder is becoming an ever-increasing difficulty plaguing law enforcement. Currently, it is estimated that PTSD and depression effect between 7% and 35% of officers [1,2].

Policing was complicated enough to begin with before 2020 brought new challenging events to law enforcement. This started with the first wave of COVID-19, quickly followed by riots, looting and civil unrest, which is still carrying on today.

If this wasn’t enough, consider the sharp contrast between being hailed as an essential worker, a hero of the community, then having every officer blamed for the death of certain individuals. Naturally, this would cause havoc on psychological health.

A recent online Police1 survey received 1,355 active-duty law enforcement officer responses. Of this number, “47% of the sample screened positive for PTSD, which is approximately 9 to 10 times greater than the prevalence seen in the general population.” Going one step further, 29% of responding officers had moderate to very severe anxiety and 37% tested for moderate to very severe depression. This number is roughly 5 times greater than the prevalence seen in the general population. So, what signs should officers look for in their co-workers and how do we prevent this?

Signs/Symptoms of PTSD

The most common signs of PTSD are: the inability to think clearly, not sleeping well (often due to nightmares), recklessness, constantly triggered by an event, going to great lengths to avoid similar situations and so forth.

Unfortunately, PTSD can be caused by a variety of factors: events involving children, serious on-the-job injuries and officer-related shootings are common ones, though any event can spark PTSD.

Preventing and Helping PTSD

The most important thing for officers and leadership to know, besides recognizing PTSD, is knowing how to help and prevent it—for both themselves and their fellow officers.

Instructors can implement techniques such as trauma and stress inoculation training or trauma awareness. Leaders can encourage officers to speak to a department psychologist after a difficult situation. Officers can utilize free resources such as Copline to speak to retired officers who understand and have undergone similar situations.

Talking about PTSD is more important now than ever. As shown in the P1 survey, many officers are reluctant to seek services due to the stigma that surrounds it. They worry that assistance would be seen as a weakness, and they fear job loss and other repercussions in the workplace.

Changing this stigma will take everyone. Police Chiefs, instructors, sergeants, fellow officers—this is a discussion we need to start now. Together, law enforcement is looking out for each other. Together, we are silent no more.

References:
1. Ruderman Family Foundation. The Ruderman White Paper on Mental Health and Suicide in First Responders, 2018.

2. Yuan C, Wang Z, et al. Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers. Psychiatry Research, 2011, 188:45-50.

 

 

Recently, VirTra’s “Mental Illness Training: A Practical Approach” training was nationally-certified through IADLEST’s NCP program. This unique V-VICTA curriculum contains 15 hours of nationally-certified training material that contains 10 lessons, an in-depth instructor booklet and corresponding training slides.

One of the topics covered in this Mental Illness training for law enforcement is Traumatic Brain Injury, or TBI. While this may seem out of place in the Mental Illness curriculum, TBI is in fact a big risk factor for conditions such as neurocognitive disorders, substance abuse and more.

About TBI

Simply put, TBI is caused by a sudden injury to the head that causes damage to the brain. This can be classified as one of two injuries: closed head or penetrating injury. These are fairly self-explanatory; closed head injuries are caused by a blow bump or jolt to the head while penetrating injuries are caused by an object penetrating the head.

Since the definition is wide, TBI can be sustained in many places and among any age group. This includes head trauma caused during intense sports such as football or soccer, falling, active duty combat or car accidents. Penetrating injuries are more intense and caused by more extreme actions, such as shrapnel, being hit by weapons such as hammers or baseball bats, or other injuries powerful enough to cause bone fragments to penetrate the skull.

Symptoms of TBI

TBI symptoms can range from mild to severe, depending on the injury and degree of severity. A good example of mild TBI are concussions, which many people have experienced and recovered from. However, the more intense forms and symptoms of TBI include serious physical and psychological symptoms, comas or even death.

Symptoms of Mild TBI: These include brief loss of consciousness, headaches, confusion, lightheadedness, dizziness, blurred vision and trouble with memory, concentration, attention and thinking.

Symptoms of Severe TBI: Just as the cause is more severe, so are the symptoms. Officers can look for: worsening headaches, repeated nausea and/or vomiting, larger pupil(s), slurred speech, loss of coordination, weakness and/or numbness and increased confusion, restlessness and agitation.

Officer Training of TBI

As an officer, you cannot diagnose a subject with TBI or any other mental illness unless you have the proper training and credentials. Instead of teaching officers to diagnose, VirTra’s Mental Illness curriculum is designed to teach officers how to recognize a variety of potential mentally ill subjects, the best forms of interaction and how to maximize officer and subject safety.

Through these 15 certified hours and corresponding real-life scenarios, officers learn appropriate verbalization techniques, can demonstrate they recognize the different behaviors displayed and how to implement the best response through every step of the interaction. Learn more about our Mental Illness training here or view the list of V-VICTA law enforcement curriculum here.

If your department could benefit from our Mental Illness curriculum, contact a VirTra specialist today.

 

Reference:
“Traumatic Brain Injury | TBI.” MedlinePlus, U.S. National Library of Medicine, 30 July 2020, medlineplus.gov/traumaticbraininjury.html.

 

Schizophrenia, psychosis and mood disorders are often misunderstood by the public. Though it only affects a small percentage of the population, stigmas fueled by the media have caused some people to view it as a disorder that triggers violence in the people it affects.¹ Law enforcement must be cautious not to fall for such stereotypes or make assumptions based on the diagnosis.

Schizophrenia, as stated before, only affects around 1% of the national population. An even smaller fraction of those affected by schizophrenia and similar disorders have a marked increase in violence. Data shows that people with schizophrenia are actually 14 times more likely to become a victim of a crime than be arrested. ² What may increase the chances of violence, however, are the use of drugs and alcohol in combination with any disorder.

So how can an officer – or anyone, really – tell if a person they are interacting with might have schizophrenia or a similar disorder? Everyone shows symptoms differently, but in order to have a true diagnosis, a person must display certain “positive” and “negative” symptoms. Positive and negative, in this case, don’t mean whether the symptoms are positively or negatively affecting someone, but rather about adding and subtracting symptoms.

Positive symptoms:
• Hallucinations (false perceptions)
• Delusions (false beliefs that conflict with reality)
• Thought disorders
• Movement disorders

Negative symptoms:
• Reduced expression of voice tone and facial expressions
• Reduced feelings of pleasure
• Difficulty beginning and sustaining activities
• Reduced speaking

Those experiencing schizophrenia may also express cognitive symptoms such as difficulty focusing, memory problems or decision-making.
For the V-VICTA™ curriculum “Mental Illness for Contact Professionals,” VirTra staff got a chance to speak with a woman who lives with schizoaffective disorder. M – a woman in her 20’s – takes medication to control the effects of her mental illness that cause her to experience visual and auditory hallucinations as well as paranoia.

One night, M was pulled over for speeding and was visibly nervous. Due to her shaking, the officer began to ask pressing questions and seemed to believe she was on drugs. After explaining what medication she was taking, the officer let her go, but she needed to go to the hospital later on due to the trauma it caused.

“I was having all these other voices, it’s just very overwhelming” M said about the incident. We asked M what she would want officers to know about her mental illness. “Really, we’re just trying to go about our lives, do our own thing and be normal,” she replied. “Of course, sometimes it can get dangerous, anyone can get dangerous. It just really bothers me that schizophrenia is painted as this monster mental illness, and it’s not that way at all.”

While it is important to be aware of potential dangers, remember to avoid falling into the traps of stereotypes and stigmas. The first step to doing this is to understand the types of mental illness that can affect people from all walks of life – not only schizophrenia. By using the “Mental Illness for Contact Professionals” V-VICTA course, VirTra aims to prepare law enforcement for any kind of interaction.

References:
1. Wehring, H. J., & Carpenter, W. T. (2011). Violence and schizophrenia. Schizophrenia bulletin, 37(5), 877–878. doi:10.1093/schbul/sbr094
2. Brekke JS, Prindle C, Bae SW, Long JD. Risks for individuals with schizophrenia who are living in the community. Psychiatry Serv. 2001;52:1358–1366.
3. National Alliance on Mental Illness. Schizophrenia. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Schizophrenia

 

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