Responding to mentally ill inmates

The best way to keep everyone safe is to properly train your staff for emotional, medical and psychological emergencies


By Gary T. Klugiewicz

We have all had to deal with mentally ill inmates within our correctional institutions. This is getting to be an every day occurrence. A recent article highlighted the growing number of mentally ill inmates that are being held in local jails.

In the short term, there is little that jail administrators, supervisors, or individual staff members can do about this exploding problem with the exception of providing the best possible crisis intervention training for their staff. As most of you know, my law enforcement background consists of both police and correctional assignments.

One of my last assignments was as a Special Needs Captain supervising the management of 350 inmates with diagnosed mental health issues in a population of between 900 to 1200 inmates in a modern direct supervision institution. Do the math. In Wisconsin, at the time, we were the largest mental health institution in the state. Our Special Management Team consisted of psychiatrists, psychiatric social workers, and security staff and dealt with the full range of mental health issues.

What is interesting about these statistics is that if you factor in all the emotionally disturbed persons into the mix, i.e. persons with mental illnesses, persons under the influence of drugs and alcohol, and persons in current personal crisis; at some point in time, every inmate in the jail is in need of at least short term mental health care. These numbers indicate why all correctional staff members need to receive what we refer to as Point of Impact Crisis Intervention Training for Persons with Special Needs.

Since we can't, in the short term, change the type of inmate arriving at our jails and prisons, we need to prepare to keep both them and staff members physically, legally, and psychologically safe. The way you do this is to properly train your staff for these types of emotional, medical and psychological emergencies.

Crisis intervention tactic
In the State of Wisconsin, we have developed a Crisis Intervention Tactic that combines the best of Dr. Thompson's Verbal Judo Training Program and Jane Dresser's Crisis Intervention Tactics. Dr. Thompson was an English professor turned police officer who developed a worldwide Tactical Communication training network while Jane Dresser is a psychiatric nurse who developed a point of impact crisis intervention program that allows staff to intervene with the most severe crisis situations.

This crisis intervention programs builds on the Verbal Judo Program's non escalative approach to conflict resolution and begins with how a professional prepares for an encounter with a person in crisis and then follows through with street and institutionally tested crisis management strategies.

Using the Calibre Press Street Survival methodology, we know that proper response requires that an officer remain alert, be decisive, and have a preplanned practiced response in mind for all sorts of emergency situations. For crisis intervention this starts with our Pre Crisis Intervention Preparation. Once an alert staff member determines that s/he is dealing with an inmate is crisis, s/he needs to begin...

Pre crisis intervention preparation:

1. Calm yourself.

2. Center yourself and get focused.

3. Develop a strategy for the intervention.

Once these preparations are made, the staff member who is decisive and has a preplanned practiced response can then continue with the following crisis intervention strategy:

1. Try to get the person's attention:

a. Find out all you can about the inmate before approaching,
b. Come into inmate's line of sight / move in slowly
c. Introduce yourself to build rapport
d. Model calmness / talk softly and slowly
e. Don't crowd the inmate
f. Slow things down, if possible, attempt to develop a supportive environment.

2. Check on the person's perception of reality:

a. Ask questions to find out where the inmate is coming from
b. Ask the inmate what s/he is seeing /feeling
c. Determine their needs so you can get them to go where you want them to go.

3. Try to establish rapport with the person:

a. Use Tactical Communication to keep the inmate calm
b. Explain that your are there to keep everyone safe
c. Take the time to establish rapport with the inmate
d. Acknowledge how upsetting the inmate's current sensory or emotional experiences must be

4. Explain your perception of reality:

a. Explain that you have a duty to keep everyone safe
b. You may have to tell the inmate you are not seeing what they are seeing. This is a statement of fact. You do not argue with their perceptions.
c. Ask them to assist you in keeping them safe

5. Move toward resolution of the situation:

a. It is sometimes helpful to get the inmate to move to another area especially if there are other inmates in the area. Sometimes it is easier to move the other inmates from the area
b. You may want to ask the inmate to help you in finding a solution to help resolve the current situation.
c. Allow the inmate to save face, if possible, which will assist in future contacts.
d. Remember the Closure Principle – we want to attempt to leave the inmate feeling better than they were feeling at their worst. This allows for better future interactions with this inmate. In corrections, we know there will probably we future interactions. Inmates remember both good and bad experiences. Being remembered as a professional contact can make the next contact begin and end much better.

Conclusion
Responding to inmates in crisis is an ever increasing fact of life for correctional personnel. By doing it well, you will keep yourself physically and legally safer. It will reduce the stress during very volatile situations. Professional correctional personnel have to be ready. These crisis intervention tactics help to keep everyone safer.

For more information about this crisis intervention tactics, please contact Gary Klugiewicz at gtklugiewicz@cs.com.

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