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.

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