ࡱ> ~[ bjbj Cjj$lfffft"""<&(NNNNNNN$ NNNNNffNNNfNNNخ/N ig"d P/ 0< >/ffffUNIT TITLE: Dealing With Emotionally Disturbed Persons (Adults & Juveniles) UNIT NUMBER: 1.1  Maine Criminal Justice Academy 15 Oak Grove Road Vassalboro, ME 04989 Prepared by: Date: August 2009 Police/Corrections/Mental Health/District Attorney/Parents PRESENTATION METHODS / MEDIA Estimated Time Range: 2 Hours Presentation Methods/Media: Methods 1. Lecture 2. Class Discussion 3. 4. 5. Material/Equipment Requirements 1. LCD Projector 2. Lap Top Computer 3. Flip Chart/White Board 4. 5. Student Outside Assignments 1. 2. 3. 4. 5. Media 1. HOs 1-7 Lesson Plan Booklet Overview of Child diagnosis Developmental Disorders Common Medications Protective Custody Crisis Services Officers Should do This training is designed to give officers information that will help guide them when responding to calls for Emotionally Disturbed Persons, both Juveniles and Adults. Developing a protocol for response, as well as, working with agencies to provide information sharing, will help provide the proper treatment and/or detention for the adult/juvenile. Working with local agencies to develop a Crisis Plan will help reduce the amount of repetitive calls an officer receives. PERFORMANCE OBJECTIVES At the end of this unit of instruction, the student will be able to accomplish the following objectives as outlined in the lesson: 1.1 Provide a better response by early identification of at risk juveniles in crisis 1.2 Define a Behavioral Crisis 1.3 Identify the effects of mental health & disability diagnoses in youth behavior 1.4 Define a Melt Down and possible triggers 1.5 Define the cycle of a Melt Down 1.6 Define Power Struggle 1.7 Recognize juvenile mental health and behavioral issues 1.8 Recognize common psychotropic medications 1.9 List 3 interventions for behavioral crisis to help reduce the amount of repetitive calls an officer receives. 1.10 Recognize the importance of collecting information and collaboration with agencies 1.11 Provide officers with resources for youth committing crimes that also exhibit a Behavioral Crisis 1.12 Identify and divert youth better served in behavioral health out of the Juvenile Justice System. 1.13 Recognize the nature of a call when dealing with an Emotionally Disturbed Adult 1.14 Recognize the options available when dealing with an Emotionally Disturbed Adult I. Introduction: Instructor Introduction, Credentials Introduction of the Subject Introduce Goals and Objectives for this class Ask the class if they have repeat calls to the same address for adults and juveniles with Emotional Issues, or out of control Juveniles. Ask the class if they would like to discover ways to help reduce the number of repeat calls they have to the same address, and at the same time help the subjects get the help they need. II. A Juvenile in Crisis is A Juvenile Displaying One or More of the following Behaviors: A. Disruptive B. Destructive C. Violent D. Criminal E. Self-harming F. Threatening G. Assaultive III. Difficult Behaviors and Emotional Disorders A. Children and Mental Illness: Brain disorders and mental illnesses are equal Opportunity conditions and effect children and adolescents from a broad spectrum Of families. Brain researchers encourage teachers, doctors and mental health Providers to resist blaming mental illnesses on poor parenting 1. Melt Down: For children with special needs, physical or emotional, a melt down is not about using a tactic or a voluntary behavior; it is a symptom signaling that something deeper is happening. The child has moved beyond coherent and rational thought 2. Melt Down Triggers a. Lack of, or changes in medications b. Trauma (current or past) c. Change in normal routine (divorce/loss, moving, changing schools) d. Lack of child/parent coping skills e. Power struggles f. Inability to deal with conflict 3. Cycle of a Melt Down a. Agitation State lack of coping skills, Many possible Triggers b. Melt Down May be quiet or very violent, not in a normal state of mind c. Recovery State Exhaustion, may not remember events B. Primary Concerns for Officers Responding to Juveniles in Crisis 1. Public Safety (threat to self or others) Emergency evaluation 2. Jeopardy (unsafe environment) = DHHS Parent is unable to control child 3. Crime (s) committed = D.A.s Office/JCCO 4. Mental health/behavioral condition = Refer to Crisis IV. Why Collaboration is Needed A. A juvenile in crisis call involves many domains/agencies 1. Mental Health/Hospital/Crisis 2. DHHS 3. Corrections 4. District Attorneys Office 5. Community Support Agencies 6. Schools 7. Police B. Police Officers acting in isolation and failing to communicate with the appropriate Support agency may be increasing the chance of a repetitive occurrence C. Many of these calls are more appropriately handled by support agencies but they can Only help if they know about the event D. Appropriate intervention and services often leads to better long term out comes in The juveniles behavior E. Primary Collaborative Partners 1. District Attorneys Office 2. Juvenile Corrections 3. DHHS 4. Crisis/Hospital 5. Schools 6. Community Support Groups 7. Parent and Parent Support Groups 8. Police Services F. Collaboration with partners 1. The officer should make every effort to know and develop a positive working relationship with professionals from the various support agencies 2. Absence any other tactic, personal professional ongoing dialog with support agency personnel helps to foster the best interagency working relationship leading to better coordinated service delivery for the juvenile in crisis V. To effectively respond to a Juvenile in Crisis call the Officer should do the following A. Recognize a juvenile in crisis B. Understand the surrounding/causal factors C. Document critical information D. Be familiar with local and state support agencies E. Be prepared to communicate with support agencies (in accordance with state Privacy laws) F. Possess a working knowledge of each agencies responsibilities and resources G. Provide appropriate referral information to the parent H. When responding to a juvenile in crisis Call Officers should do the following 1. Determine the nature of the call 2. Public Safety 3. Jeopardy 4. Criminal 5. Combination of the above 6. Gather critical and appropriate information 7. Make the scene safe 8. Make a decision which action is most appropriate a. Transport for an emergency mental health evaluation b. Refer to crisis c. Refer to DHHS d. Provide support agency information to parent/guardian e. Charge the Juvenile f. Call the JCCO VI. Criminal Behavior VS Behavioral Crisis A. Any criminal behavior should be investigated along with any behavioral health Concerns B. Recognizing and addressing mental health and disabilities should result in less Officer responses and a better future for the juvenile C. Why Capture Information 1. Police observation and information gathering is essential because it gives a realistic unbiased picture of what is happening in the home at the time of the melt down/behavioral crisis 2. This is critical information for support agencies to be able to successfully intervene 3. Police Officers are in the unique position to identify children at risk at an early state 4. Police intervention through collaboration/communications with appropriate support agencies can expedite the delivery of critical services to the juvenile and family 5. Early intervention reduces the occurrence of increased disruptive/criminal behavior D. Responding officers should avoid engaging in power struggles 1. Power struggles may damage your rapport with the youth of other youth who observe the interaction 2. There are 4 common types of power struggles: a. The individual challenges your authority b. The individual pushes your buttons to shift the attention from their behavior to you c. Making threats or giving ultimatums d. Bringing up non-pertinent and non-related past history E. De-escalation Strategies with Children & Adolescents 1. Dont get into a power struggle, focus on the 3 Ss a. Safety b. Support c. Stabilization of the biological, cognitive and emotional status of the child 2. Approach slowly, create a calm and a sense of safe adult control a. Scan for possible dangerous escape routes or objects b. Physically position self in the least threatening posture possible, but be prepared to move quickly c. Simply introduce yourself and let the child know that you are there to help d. Go slowly and try not to introduce any unnecessary strangers into the situation e. Keep the child informed of what you are doing so as to reduce any startle response f. Use redirection if at all possible g. Use ignoring and work not to be baited or triggered by language, name calling and oppositional behaviors h. Assess the developmental age of the child. Dont let chronological age fool you i. Assess for any comforting individuals or objects to build a relationship j. As the child stabilizes, check on the basic needs as appropriate such as food, liquids, blanket, comfort from a loved one.. k. Know your own triggers when dealing with parents, teens and children VII. Officers should possess a thorough understanding of Maines Juvenile Code A. Recognize the underlying premise of the code is different than the adult code 1. The district attorneys office and JCCO approach juvenile cases with the goal of diverting out of the criminal justice system at the earliest opportunity (in all but the most serious offences) 2. Officers working with a misunderstanding of this process may become frustrated and disillusioned with the system B. Dangers of Detention 1. Can increase recidivism 2. Increases risk of getting to know other at risk youth (peer deviance) 3. Makes mentally at risk youth worse 4. Increases risk of self harm 5. Youth with special needs fail to return to school C. Title 15 1. Purposes. The purposes of this part are: To secure for each juvenile subject to these provisions such care and guidance, preferably in the juveniles own home, as will best serve the juveniles welfare and the interests of society; (1997, c. 645, 1 (AMD).) To preserve and strengthen family ties whenever possible, including improvement of home environment; (1977, c. 520, 1 (NEW). ) To remove a juvenile from the custody of the juveniles parents only when the juveniles welfare and safety or the protection of the public would otherwise be endangered or, when necessary, to punish a child adjudicated, pursuant to chapter 507, as having committed a juvenile crime; (1997, c. 645, 1 (AMD).) To secure for any juvenile removed from the custody of the juveniles parents the necessary treatment, care, guidance and discipline to assist that juvenile in becoming a responsible and productive member of society; (1997, c. 645, 1 (AMD).) To provide procedures through which the provisions of the law are executed and enforced and that ensure that the parties receive fair hearings at which their rights as citizens are recognized and protected; and (1997, c. 645, 1 (AMD).) To provide consequences, which may include those of a punitive nature, For repeated serious criminal behavior or repeted violations of probation conditions. (1997, c. 645, 1 (NEW).) D. Differences between Juvenile and Adult Criminal code 1. Adult code is punitive a. Fine b. Imprisonment 2. Juvenile code is rehabilitative a. Assessments b. Referrals c. Treatment d. Punishment is last consideration E. How Police Intervention can Help Improve Outcomes through diversion from Juvenile Justice 1. Recognizing difference between criminality and behavioral crisis 2. Identify possible need for services 3. Supporting/Empowering parents in engaging services 4. Gather appropriate information for purposes of documentation and referral VIII. Mental Health Information A. Some Mental Health Statistics Nationally 1 in 5 children and adolescents have a mental health disorder 1 in 10 have a serious emotional disturbance*Serious Emotional Disorder means that the disorder disrupts daily functioning in home, school or community. Mental Illness strikes individuals often during adolescence and young adulthood Mental illnesses are treatable 50% - 70% of youth in the juvenile justice system have at least one diagnosable Mental/Behavioral Health issue 25% to 33% of these youth had Anxiety and Mood Disorders Nearly half of incarcerated girls meet criteria for PTSD 13.7% of youths aged 14-17 considered suicide in the past year Only 36% of those at-risk children received mental health treatment or counseling Youth who used alcohol or illicit drugs in the past year were more likely to consider taking their own lives B. High Risk Population for Violence 1. Previous history of violence 2. Under influence or withdrawing from a substance that has the potential to impair the brain 3. Has impaired executive functions 4. Is exhibiting symptoms of psychosis, increases if command hallucinations present 5. Male Gender 6. Has a neurological impairment 7. Is exhibiting symptoms of dementia 8. Has symptoms of antisocial or borderline personality disorder 9. Weapon availability and preoccupation with violent thoughts 10. Adolescent and early twenties (high risk for suicide) 11. Previous history of an attempted suicide that had potential to be lethal a. More planning than impulsive b. Not allow chance of discovery c. No prefaced signal for help C. Self Injurious Behavior 1. Direct deliberate, immediate self harm, such as cutting, burning, hitting 2. Indirect/passive a. Refusing medical treatment b. Not taking medication c. Smoking/alcohol d. Putting self in harms way 3. Not suicidal or sexual in nature 4. Para-suicidal behavior 5. Wanting to feel better versus wanting to feel nothing 6. Self define between self injurious behavior and suicidal behavior 7. SIB is alternative to suicidal behavior D. Mental Illness Requires Treatment 1. Due to the many influences on children, the neurochemistry of the brain can change and their best efforts at sustaining balance are not enough. a. Medication or other therapeutic processes may be required to restore balance b. Punishments alone do not restore the brain chemistry or improve behaviors in a child needing therapeutic interventions E. Disruptive Disorders 1. Attention Deficit Hyperactivity Disorder (ADHD) a. Inattention Careless mistakes Difficulty paying attention Not listening Failure to complete tasks Easily distracted Forgetting Losing things b. Hyperactivity Fidgeting Excessive movement Talkative Blurts out answers Impulsivity Interrupting others Intrudes upon others Can not stay seated 2. Oppositional Defiant Disorder (ODD) Pattern of negative, hostile and defiant behavior Symptoms include: a. Deliberately annoying b. Often angry c. Resentful d. Defies rules e. Argumentative 3. Conduct Disorder: Pattern of behavior in which the basic rights of others and societal norms or rules are violated (according to age). a. Aggression to people and animals b. Destruction of property c. Theft d. Truancy, run away, violate curfew 4. Interventions for Disruptive Disorders should address immediacy; instant gratification; distraction as an intervention F. Mood Disorders 1. Depression in Children a. Separation Anxiety b. Behavior problems c. Family history of mood disorder or substance abuse d. Unrealistic fears/anxieties/phobias e. Drug and/or alcohol use f. Negativity/irritability g. Aggressiveness or overactive behavior 2. Bipolar Disorder in Children a. Sleep disturbance and irritability dating from infancy b. Separation anxiety c. Night terrors d. Phobias and/or school phobia e. Raging and tantrums f. Oppositional behavior g. Rapid cycling of mood h. Sensitivity to stimuli i. Distractibility and hyperactivity j. Impulsivity and risk taking k. Grandiosity and aggressiveness 3. Interventions for Mood Disorders, support self regulation; de-escalation; identify triggers; using language to convey feelings G. Anxiety Disorders 1. Generalized Anxiety Disorder, overwhelming feelings of anxiety that impair functioning 2. Panic Disorder, Panic attacks significant physical symptoms to include pulse racing, hyperventilating, chest pain, dizzy, etc. Develop abruptly and reach peak within 10 minutes 3. Phobic Disorder, Intense anxiety when faced with specific stressor (i.e. closed spaces, heights, insects, social situations). In children, anxiety may be expressed by crying, tantrums, freezing, clinging. 4. Post Traumatic Stress Disorder, Nightmares, hyper vigilance, feelings and reacting as if in the traumatic event, psychological distress at exposure to cues that resemble an aspect of the traumatic event 5. Obsessive Compulsive Disorder, Obsessions are thoughts, impulses or images that are experienced as intrusive and inappropriate and cause marked anxiety/distress. Compulsions are repetitive behaviors/mental acts the person feels driven to perform (i.e. hand washing, ordering, checking, counting, repeating phrases silently). 6. Interventions for Anxiety Disorders, address fears and increase comfort level; increase mastery over fear H. Types of Interventions for Mental Illness 1. To improve behavior, thinking, and brain biology problems, children and adults need several kinds of interventions: a. Biological (medications). b. Social (behavior plans) c. Educational (accommodations and support) d. Substance abuse counseling I. Barriers to Treatment 1. Suicide is the 2nd leading cause of death among 15 24 year olds. Over 90% of children who die from suicide have a mental disorder 2. Among youth in juvenile justice facilities, 50% to 75% have mental illness 3. 25% to 33% of these youth had Anxiety Disorders or Mood Disorders 4. Frequently have more than one Co-occurring mental and substance use disorder 5. Up to 80% of children suffering from mental illness fail to receive critically needed treatment 6. Children receiving special education and designated with emotional disturbances fail more courses, earn lower grade point averages, miss more days of school and are retained at grade more than students in any other disability category. J. Additional considerations for law enforcement 1. Suicide prevention 2. Access to treatment 3. Homelessness in Youth 4. Substance Abuse 5. Issues of Independence/development and needing to feel accepted by peers 6. connection with community vs. alienation K. The Developmental & Physical Disability Spectrum: 1. Developmental disabilities are a diverse group of severe chronic conditions that are due to mental and/or physical impairments. People with developmental disabilities have problems with major life activities such as language, mobility, learning, self-help, and independent living. Developmental disabilities begin anytime during development up to 22 years Of age and usually last throughout a persons lifetime. 2. Autism, A pervasive Developmental Disorder (PDD), Onset by 36 months with serious to profound disturbances in language, social interactions, interests, and motor behaviors. Disturbance are highly repetitive, stereotypical and resistant to change. 3. Aspergers, Also a Pervasive Developmental Disorder, Intact language and intellectual development, but highly restricted capacity social and emotional interactions 4. Mental Retardation a. Limitation in functioning related to limited intelligence b. IQ below 70 (90% mild MR) c. Issues relating to: communicating, social skills and self care d. Affects 3 out of every 100 persons e. Important to consider developmental age vs. chronological age when dealing with a youth with mental retardation 5. Cerebral Palsy, refers to a group of disorders that affect a persons ability to move and to maintain balance and posture. It is due to a non-progressive brain abnormality, which means that it does not get worse over time, though the exact symptoms can change over a persons lifetime. People with cerebral palsy have damage to the part of the brain that controls muscle tone. Muscle tone is the amount of resistance to movement in a muscle. It is what lets you keep your body in a certain posture or position. 6. Hearing Loss, Impairments in hearing can happen in either frequency or intensity, or both. Hearing loss severity is based on how well a person can hear the frequencies or intensities most often associated with speech. Severity can be described as mild, moderate, severe, or profound. The Term deaf: is sometimes used to describe someone who has an approximately 90 dB or greater hearing loss or who cannot use hearing to process speech and language information, even with the use of hearing aids. The term hard of hearing is sometimes used to describe people who have a less severe hearing loss than deafness 7. Vision Impairment, means that a persons eyesight cannot be corrected to a normal level. Vision impairment may be caused by a loss of visual acuity, where the eye does not see objects as clearly as usual. It may also be caused by a loss of visual field, where the eye cannot see As wide an area as usual without moving the eyes or turning the head. 8. Brain Injury, There are two types of brain Injury a. Traumatic Brain Injury is a result of a direct blow to the head i. about 50 70% if all TBI are the result of car accidents. ii. Slips and falls iii. Violence iv. Sports related injuries b. Acquired brain injury is one that has occurred after birth, and is not hereditary, congenital, or degenerative. Common causes are: i. Airway obstruction ii. Near drowning iii. Electrical shock iv. Lightening strike v. Blood loss, heart attack, stroke, aneurysm IX. Common Medications Used for Youth A. If you hear a youth is on medications it should be treated as a major indicator that There may be something else going on for this youth. Commonly Used Psychotropic Medications are as follows: 1. Antidepressants a. Prozac b. Zoloft c. Lexapro d. Celexa e. Luvox f. Wellbutrin g. Cymbalta h. Effexor 2. Mood Stabilizers/Antipsychotics a. Abilify b. Seroquel c. Geodon d. Zyprexa e. Risperdal f. Depakote g. Lithium h. Lamictal i. Thorazine 3. Stimulants a. Ritalin b. Concerta c. Ritalin LA d. Focalin e. Daytrana f. Adderall g. Vyvanse h. Strattera 4. Antianxiety a. Buspar b. Vistaril c. Ativan d. Klonopin e. Valium f. Xanax g. Doxepin 5. Other a. Clonidine b. Tenex c. Propranolol d. Trazodone e. Remeron f. Melatonin g. Benadryl X. Gathering Information and Information Sharing A. It is important to start identifying and collecting information for those youth in the Realm of behavioral crisis. Share information between the below agencies. No consent is needed unless otherwise indicated. 1. Law Enforcement 2. DHHS 3. Hospital *contact your regional crisis provider and discuss parameters of receiving information re. With or without consent 4. Crisis Services 5. Non-emergency crisis (with consent) 6. Community Providers (with consent) 7. Schools (only with imminent threat) B. Hospital, When an officer transports a juvenile to the hospital for an emergency Mental health evaluation information sharing is critical. 1. Either a written or verbal report of incident should be provided for the hospitals review to assure evaluators fully understand the crisis. 2. Self harming/threatening and violent behavior/statements should be noted 3. The child may be released prematurely if accurate information is not provided to the hospital. C. Red Flag Behaviors 1. Bullies 2. Threatens 3. Intimidates 4. Used a weapon 5. Physically cruel to people 6. Physically cruel to animals 7. Stolen property 8. Destroyed property 9. Broken into someones home/car 10. Lies 11. Stays out past curfew 12. Runs away 13. Truant from school 14. Plays with fire 15. Acts out sexually D. Demographics 1. Date, Time, location, case number of incident. 2. Juvenile biographical information. Name, DOB, height, address, weight, eye color, hair color 3. Juvenile general health/injuries 4. Parent/guardian (denote relationship) biographical information Contacted yes/no 5. Describe behavior that generated the police response 6. List possible criminal behavior committed. E. Basic Information to Capture 1. What specific behavior generated the call 2. Parents concerns (juveniles behavior) 3. Include 911 call information and excited utterances about behavior and juvenile history. 4. Statements made about behavior 5. Statements made about medication 6. Statements made about mental health conditions 7. Statements made about fear of the child 8. Statements made about assaults/threatening 9. Statements made about parents inability to control the child (out of control juv) 10. Number of times the police were called because of the childs behavior? The last time and date. 11. Would you consider the juvenile a threat to self or others? 12. Is the juvenile on probation/who is his/her P.O. Contacted Yes/NO 13. Voluntary Information a. Medications b. Diagnoses c. Current community services d. Case manager e. Educational Information f. Other concerns in the family g. Is the child receiving services (counseling) currently? h. From What agencies? i. Who is the case manager (s) ? j. What medications is the child taking? k. What diagnosis does the child have? l. Last time medication was taken m. How many times has your child had a crisis evaluation n. Does the child use drugs/alcohol? o. Where does the child attend school/grade? p. Are juveniles associates/friends in trouble with the law/school? 14. Voluntary Parent Questions a. Do you have concerns for your child? b. Please explain what additional services you feel would help you/family? XI. Crisis Plan A. Many families who are receiving support services may have a crisis plan. B. The officer should ask to review the plan C. The officer should determine if the plan appropriately identifies a crisis and the Appropriate time to call the police (911) D. The officer should work with the parent/agency to improve the plan if necessary E. Many parents and social service agencies have a fundamental misunderstanding Of the role and abilities of the police F. Crisis plans developed without input from police or an understanding of the polices Role often call for police intervention for misguided reasons G. Parents may incorrectly call the police to discipline their child, take their child out Of the home or frighten their child H. Police Officers should educate the parents about what the Police can and cannot do XII. Police Response to Emotionally Disturbed Adult A. Recognize the nature of the call 1. Is the subject a threat to self or others (imminent) 2. Has the subject committed a crime 3. Is the subject in a jeopardy situation (non-emergency) 4. Is the call a combination of the above conditions 5. None of the above conditions apply B. If the subject is a threat to self or others, they may be taken into protective custody And transported for an emergency mental health evaluation based upon the following Maine Statute. T 34-B (3862. Protective Custody C. The officer may also voluntarily transport the subject to a mental health facility. 1. A voluntary transport precludes the Protective Custody statute. 2. Often assistance from the family or friends is useful under this action D. If a crime is committed by the subject 1. Arrest and/or summons the subject 2. Transport to a correctional facility if warranted 3. Transport to a hospital for an evaluation if warranted *Once under arrest the officer must either maintain custody until cleared by the mental health facility or bail the subject through either a bail bondsman or personal recognizance. E. If the subject is in a jeopardy situation, jeopardy consists of a situation where the General living conditions are/or capability for self care of the subject are unhealthy. 1. Call your local Crisis Service provider who will provide services for an evaluation of the subject. 2. Crisis services will coordinate with other responsible agencies to provide needed services. The department of health and human services subcontracts out their crisis services to regional private crisis providers around the state 3. Crisis services state wide number is 1-888-568-1112 F. If the subject has a combination of conditions 1. The officer will make a decision which condition requires immediate action and act accordingly. Priority starting with a life safety threat and or the magnitude of the criminal act. 2. In certain circumstances multiple actions can be taken concurrently a. Arrest or summons and protective custody b. Summons and call Crisis c. Call crisis and disengage from the subject if not imminent threat G. If the subject is not a threat, not in jeopardy and has not committed a crime 1. Disengage 2. Call crisis services for support if appropriate 3. Collaborate with family or friends to assist the subject if appropriate 4. Collaborate with the community to mitigate future calls for service if appropriate Conclusion: Review Objectives and Answer Questions Bibliography Subject Matter Experts: Robert Barton, DHHS NAMI Maine 2009 Jay Pennell Juvenile Corrections Kathy Mckechnie, York County DA JV Prosecutor Laurie Cavanaugh, G.E.A.R. Parent Network Thersesa DAndrea , National Parent Federation Deana Mullins LMSW-CC, Goodall Hospital Pam Richards, DHHS Janice Teasenfitz LSW, DHHS Sgt. Jonathan Shaprio, Maine State Police Kim Foster, NP, Psychiatric provider, Long Creek Youth Development Center Jennifer Goodwin, Crisis Response Services, York County U. S. Department of Justice. (2006). People with mental illness. Office of Community Orientated Policing. Retrieved June 10, 2009.  HYPERLINK "http://www.cops.gov" www.cops.gov: Cordner, G. National Center for Mental Health and Juvenile Justice. (2001). Blue print for Change: A comprehensive model for the identification and treatment of youth with mental health needs in contact with the juvenile justice system. Delmar, NY: Skowyra, K. & Cocozza. Council of State Government. (202). Criminal Justice Mental Health Consensus Report. Police Executrive Forum.  HYPERLINK "http://www.policeforum.org/library" http://www.policeforum.org/library Dr. Ross Greene, Quotes and information Brenda Smith Myles & Anastasia Hubbard 2005 Justice Policy Institute, Barry Holman and Jason Ziedenberg SAMHSA 2009  HO Lesson Plan Booklet 1.1 1.3 It is important to note that all children that have difficult behaviors do not have a mental illness. Likewise, children that have mental illnesses do not always have challenging behaviors. 1.2 1.4 1.5 *Everyone deals with lacking skills differently, police usually called on the extreme end (Brenda Smith Myles & Anastasia Hubbard 2005) Ask students what agencies they may deal with when handling a juvenile call. 1.10 Show Criminality/Behavioral Flow Chart 1.11 1.10 Ask students what a power struggle might be 1.6 Ask students to list de-escalation strategies 1.7 HO Overview of Childhood Diagnosis Ask students to list types of Mental Illness HO Developmental Spectrum Ask students to explain what they think a developmental disability is HO Common Medications Ask students to list medications they are familiar with 1.8 1.9 1.10 Felonies to be highlighted The excited utterance on the 911 tape are critical because the information gained is important to the support agencies to intervene appropriately and gain accurate understanding of the event. Very important to demonstrate the need for additional services 1.12 1.13 Hand Out T 34-B (3862. Protective Custody. 1.14 HO Overview of Crisis Services HO Officers should do the following  1.1 List two behaviors that indicate that a Juvenile is in Crisis. Disruptive, destructive, violent, criminal, self-harming, threatening, assaultive 1.2 A Melt Down is a sign of behavioral Crisis T F 1.3 A diagnoses of a disability in youth behavior is no concern T F 1.4 Define a Melt Down The child has moved beyond coherent and rational thought 1.5 List the 3 cycles of a Melt Down. Agitation State, Meld Down, Recovery State 1.6 It is not wise to get into a power struggle with a Juvenile. T F 1.7 Self Injurious Behavior is a mental health problem. T F 1.8 Antidepressants, Mood Stabilizers, and Anti-anxiety medications are not used to treat mental illness. T F 1.9 List 3 agencies in which to share information to help a Juvenile in Crisis. Law Enforcement, DHHS, Hospital, Crisis, Community Providers, Schools 1.10 It is important to collect as much information as possible when you respond to a call involving a juvenile in crisis T F 1.11 Officers should work with families and agencies to help develop the crisis plan T F 1.12 Our goal is to identify and divert youth better served in behavioral health out of the juvenile justice system. T F 1.13 List 3 different types of calls an officer deals with when engaging an Emotionally Disturbed Adult. Threat to self or others, crimes committed, jeopardy situation, combination of all, None of these. 1.14 There may be times that a call does not need any police involvement, and you may just call family to provide support. 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