Written by: Nicole Florisi, Law Enforcement Subject Matter Expert – Investigative Focus
There is a great deal of stigma attached to post-traumatic stress disorder (PTSD) in the first responder community. With all the “talk” of officer wellness, officer mental health, and resiliency there is not the decrease in negative outcomes that one would like to see overall. Why is that? In some cases, it is the label of having a disorder. Words are powerful and there is a distinct difference in the word disorder versus injury. In other cases, it is nothing more than checking the boxes and “talk” about what should be done to increase positive outcomes. We know where talking gets us. Nowhere, just like it does in the training environment. If we do not teach, implement, and model the skills we want first responders to have, we are not doing what is best.
There is a large focus on the “management” of PTSD and a lot less focus on the areas of prevention and mitigation. There is weakness in the training and application of resiliency skills for first responders to succeed. We have come to a point where individuals stigmatize the word resiliency. If you do not want your officers to have the grit and resiliency to move through the trauma they experience, you are part of the problem.
I was contacted a few months ago by an officer who had the experience of handing a case involving the burned bodies of children. He was struggling (his words) and looking for someone to talk with that would be able to support him while he worked through these events. Unfortunately, the clinician he originally saw started crying when he was sharing the events that brought him to treatment. The clinician told this officer that they could not treat him, as the events that he saw were too “overwhelming for them.”
I am proud beyond belief that this officer still sought treatment. The individuals in his department were not supportive either. He was told by someone in upper management that seeing burned bodies was part of the job and he was weak. That person told this officer that PTSD was “a bunch of crap for people who couldn’t handle life.” And we wonder why officers experience challenges in the recovery process.
On an anecdotal level, I have spoken with several first responder psychologists and therapists. The main barrier to treatment that officers face is not usually moving through the critical incident. The barrier is agency betrayal. Sit with that for a minute. We should provide an environment where it is emotionally safe for first responders to work through their experiences.
The book One Badge, One Brain, One Life: Preventative Maintenance for Your Brain While in the Line of Duty is a fantastic resource for all law enforcement. This book provides information, education, and practical skills to reduce and mitigate symptoms of trauma. You can purchase the book here: One Badge One Brain One Life | Tapia Counseling & P (drrobbie.org)
At VirTra, our V-VICTA® curriculum supports officer wellness. It provides a foundation for coping and resiliency skills that can mitigate traumatic symptoms. VirTra simulators can be a part the process of reintegration for officers after a critical incident. This entails having a framework rooted in best practices that minimizes the risk of enhancing dissociation, derealization, and depersonalization that can accompany traumatic experiences. Both education and conversation are part of reducing stigma. No matter your rank or your role, you can be part of the solution.
Behavioral health training is very broad, yet the topics are specific. Behavioral health and mental illness cover a critical range of topics, diagnoses and states of mind that every officer must be familiar with.
What comes to mind when you hear “behavioral health” or “mental illness”? Often, people think of extremes, such as suicide or schizophrenia. The term “behavioral health” includes depression, anxiety, trauma and PTSD—illnesses officers are more likely to encounter in the field.
Knowing that behavioral health’s range covers illnesses that are more commonplace in addition to those rarer, it is easy to see how 1 in 5 American adults currently live with a behavioral health issue. Officers may encounter those with a mental illness at any time, so they must know how to recognize the various signs and the proper ways of connecting.
To make training on this expansive topic easy, VirTra created “Mental Illness Training: A Practical Approach”, a nationally-certified course that teaches officers how to recognize and interact with these subjects. This V-VICTA® curriculum includes 15 certified training hours through ten lessons, along with corresponding presentations, tests, realistic video scenarios and more for well-rounded training.
The topics covered in this 15-hour course include:
Departments are encouraged to teach this topic more in-depth. It is not heavily taught nationwide, despite every community having members with a mental illness. Start improving community safety, officer knowledge and help for all. Learn more about this training and how to implement it into your regimen by contacting a VirTra representative.
June is a fun month for society. People celebrate summer, fresh produce, long days and relaxation. While this time is enjoyable, it is also a time to remember that June is PTSD Awareness Month. June 27th is specifically designated as PTSD Awareness Day. This month, we encourage people to take some time to think of and care for veterans, police officers, victims of abuse and other individuals they may know who are suffering the effects of trauma.
Law enforcement personnel specifically are in the unique position where they may work with individuals suffering from PTSD. They may be suffering from PTSD while simultaneously helping those with the disorder. After all, due to the nature of the job, officers may experience PTSD after responding to difficult, traumatic or troublesome calls. According to a past study, 35% of officers met the criteria for PTSD1. Now compare this to PTSD among the general population—3.6% for men and 9.7% for women2—and it is easy to see why PTSD is being discussed more in departments and why special care must be taken for our officers.
Officers must be taught to recognize PTSD symptoms and know how to help those affected, including their co-workers. This is where VirTra can help. To help educate officers, VirTra created the curriculum “Mental Illness Training: A Practical Approach”, which is a combination of classroom and science-based simulation training. The curriculum includes 15 training hours though lessons such as PTSD, as well as other mental illnesses, including: depression, suicide, anxiety, crisis de-escalation and more. Officers learn the material in a classroom setting before engaging in simulated scenarios to practice recognizing the signs and communicating with the subject.
Mental health training for officers is an essential addition to any department’s curriculum. Mental health and PTSD are becoming increasingly more discussed, and as such, improving departments. Help us take care of your society and officers by increasing PTSD awareness and training.
Talk to a VirTra representative to get started.
As a member of law enforcement, think for a moment about how many people you interact with daily and how many people you talk with in one shift. Effective communication is a critical piece of the job. We interact with individuals from all walks of life. That includes individuals who have mental illness. The key to effective communication is behavior recognition to choose the best communication style for the individual and the situation.
When it comes to interacting with individuals who have mental illness, choosing the communication style that best fits the situation is the best course of action. We do not communicate with a diagnosis, but with a human being.
The question we should ask ourselves: does the diagnosis itself matter? In most cases, it does not.
A diagnosis is informative at best. What is more important from a law enforcement perspective is we choose the right type of communication for an individual and the behavior exhibited at the time of interaction. The risk comes from misreading behaviors from individuals and not from whether a person has a diagnosis or not.
However, there is a large part of the population that has a diagnosis for a mental illness at any given time. According to the National Institute of Mental Health, nearly one in five adults in the U.S. have some type of mental illness. Mental illness is a broad term – there are many symptoms that accompany different diagnoses. Awareness of behavior is a key factor in how an officer interacts with any person, mental illness or not.
Mental illness doesn’t discriminate. Some disorders are genetic and others are caused by chemical imbalances in the brain. They can be influenced by many factors, environment included.
Law enforcement officers interact with individuals who may have one or more of the following diagnoses:
It is important to emphasize that members of law enforcement should not attempt to diagnose; the goal is familiarization of behaviors. Individuals who have a serious mental illness may find themselves more likely to have an encounter with police. In fact, persons who have a mental illness are more likely to be victims of a crime. That doesn’t mean there are not interactions that have violence, volatility, and instability. But that comes from anyone we deal with and is not relative to mental illness alone.
Some strategies for dealing with crisis or crisis-like behavior may include:
Another critical component of understanding mental illness is intervention. When possible, encourage individuals to seek help. Knowing what is available and providing information lays a foundation for showing you care and that there is hope.
Never sacrifice safety for a behavioral health intervention. We have a responsibility to the individual, the public, and to ourselves. Abandoning sound tactics is never the answer.
Dual diagnosis is a known problem – one where a person experiences both a mental illness and a substance use disorder simultaneously. People use substances for various reasons. There is an correlation of trauma and substance use.
Some diagnoses such as schizophrenia or bipolar disorder may have behaviors that mimic substance use. Recognizing the differences is not necessarily possible. That is why addressing behavior is the key.
Autism spectrum disorder affects the way a person socializes, speaks and acts. It is called a spectrum for a reason – there are some people with autism that have barely noticeable traits, while others are entirely nonverbal and rely on a caregiver to help them communicate.
There have been instances where a person on the autism spectrum have experienced difficulties and trauma as officers thought that drugs played a part in the behavior rather than there was a foundation of miscommunication. The number of similar incidents involving members on the spectrum creates the notion that there is a lack of training in this field.
When designed and tested correctly, simulation training provides a realistic environment for law enforcement members to practice in. Video-based simulation is even better, as it features real people and allows officers to pick up on subtle visual cues (such as facial expressions and small movements) that cannot be replicated with CGI.
The right kind of simulator has high-definition video, numerous scenario branching options and thorough debrief capabilities. When interacting with an on-screen subject, officers should practice to recognize various behaviors and choose the appropriate verbal techniques for that situation.
Much more than hardware, the vital part of simulation training is the quality of the content. Do officers truly learn something from what they are experiencing in the simulator? VirTra ensures content quality and skill transfer by submitting all curriculum – including our Mental Illness and Autism Awareness courses – to IADLEST for NCP certification.
Working and creating partnerships with industry experts has assisted VirTra in creating coursework that benefits law enforcement. With 15 hours of mental illness curriculum and 2 hours of autism curriculum, police trainers can have effective training at their fingertips. The pre-made curriculum doesn’t just include the scenarios, but also student handouts, instructor manuals, testing materials and more. It is intended to make the instructor’s job easier with coursework that can be used right out of the box.
In 2021, the state of Utah began requiring that law enforcement members obtain training hours solely dedicated to autism awareness, thanks to the Utah Attorney General’s Office. Some of the hours involve the use of a VirTra training simulator due to its immersive qualities and the detailed course structure.
“The beautiful thing about the system is that we can change the dialogue, we can change the reaction, the response and we can make it harder [or] better depending on how the officer is navigating this situation. We worked with families with children with autism spectrum disorder; we worked with experts in the education field, in the medical community, to behavioral scientists, to actually try to create and develop these modules.” – Sean Reyes, Utah Attorney General (Quote: ABC News)
By having the officers at your agency become familiar with the concepts of mental illness and autism spectrum disorder, they are keeping both themselves and their communities safe. It allows agencies to build trust and confidence from the community by making an effort to understand all members within it.
If you wish to learn more about VirTra’s coursework and how we combine simulation technology and adult learning, contact us.
Article originally published by Officer.com
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.
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:
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:
‘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.
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.
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.
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.
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.
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:
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.
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.
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:
• Substance Use
• 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.
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.