LD 37-Class 94 copyLearning Domain 37
People with Disabilities
LBPD ACADEMY CLASS 94
Est. 1996
•MET1: Officer Andre Booker & Clinician Grace Bescoby, MHCRN
•MET2: Officer Cris Costa & Clinician Emily Brennan, LCSW
•MET3: Officer Tonya Dean & Clinician Lovella Parcasio, MHCRN
•MET4: Officer Armando Garcia & Clinician Marlo Bautista, MHCRN
•MET5: Officer Efrain Cervantes & Clinician Myha Agustin, LCSW
•MET6: Officer Mark Brunson & Clinician Samantha Lopez, LMFT
Long Beach Mental Evaluation Team
Public Perception
Kelly Thomas
CLIP CUT TO 2 MINUTES 59 SECONDS
VIDEO
SEEING THE PERSON AND NOT JUST
THE ILLNESS
POST-Did you know?
VIDEO
Learning Need #1
Disability Laws
The Americans with Disabilities Act
and the Rehabilitation Act of 1973:
Written to provide clear and comprehensive
mandates for the elimination of discrimination
against individuals with mental and physical
impairments.
•Employment•State and Local Government•Transportation•Public Accommodations•Telecommunications
Guidelines offered by ADA are
separated under five categories:
Americans with Disabilities Act
VIDEO
How does ADA
Impact Law Enforcement?
The ADA applies to all law enforcement facilities
(including local detention facilities)
Accommodation must be made for
inmates with specified disabilities
People with disabilities are entitled to protection and
services that are equal to the general population
Learning the behavior signs and
indicators of various special conditions
can assist officers in identifying the proper
intervention to bring the situation to a
quick and safe conclusion
Types of Disabilities
A disability may be physical,
cognitive, mental, sensory,
emotional, developmental, or
combination
A disability may be present from birth, or
occur during a person’s lifetime. It
substantially limits a person from
actively taking part in one or more major
life activities
A physical or mental impairment that
substantially limits a person from
actively taking part in one or more
major life activities
•walking•seeing•hearing •speaking •breathing•learning•performing manual task•thinking or concentrating •interacting with others •working
A major life activity can be any one of the major
functions that an average person can perform with little
or no difficulty. These include, but are not limited to:
Types of Disabilities
•Physical/Developmental
Disability
•Mental disability
What are some physical disabilities?
•Intellectual disability •Cerebral palsy •Epilepsy•Autism spectrum disorder•Other disabling condition (e.g.,
Down’s Syndrome, Tourette’s
Syndrome, etc.)
What are some Developmental Disabilities?
A mental disability refers to a group of disorders
that can cause disturbances in thinking, feeling,
or relating to others. They often result in an
inability to cope with the ordinary demands of life.
The two primary categories of mental
disability are:
Thought disorders (e.g.,
Schizophrenia or other
psychotic disorders)
Mood disorders (e.g., bipolar
or major depression)
Walnut Creek Police-OIS Video
AT THE END OF THE DAY PEOPLE WON'T
REMEMBER WHAT YOU SAID OR DID, THEY
WILL REMEMBER HOW YOU MADE THEM
FEEL. —DR. MAYA ANGELOU —
People with disabilities are capable of
committing crimes. They are not relieved
from their obligation to obey the law
Once the scene is stabilized and
there is no threat to life then the
officer has a duty to reasonably
accommodate the person’s disability,
but not before.
Hainze v Richards
Learning Need # 2
Intellectual/Developmental Disabilities
Willowbrook State School
VIDEO
Lanterman Developmental
Disabilities Services Act
The Lanterman Developmental Disabilities
Services Act, known as the “Lanterman Act,” is
an important piece of legislation that was passed
in 1969. This is the California law that says
people with developmental disabilities and their
families have a right to get the services and
supports they need to live like people without
disabilities.
The Lanterman Act: Video
Developmental Disability
means a disability which:
•Manifests before an individual attains the
age of 18•Continues, or can be expected to
continue, indefinitely•Constitutes a substantial disability for that
individual (WIC 4512(a))•Includes but not limited to: ID, Cerebral
palsy, autism spectrum disorder,
epilepsy, etc.
Impact on Law Enforcement
The Lanterman Developmental Disabilities Service Act is not
written specifically for law enforcement application; however,
it does impact law enforcement agencies and department
policies and guidelines.
Intellectual Disability
•ID formerly mental retardation, is characterized
by below-average intelligence or cognitive
ability and a lack of skills necessary for day-to-
day living.
•There are varying degrees of ID, from mild to
profound.
•I/DD disabilities originate before adulthood (age
18) and continue throughout the person’s
lifetime
General behavioral indicators can include:
•confused and/or disorientation•slow response to commands•muscle control difficulty•limited mobility•seizure disorders•self-endangering behavior•inappropriate responses to a situation•lack of awareness of dangerous situations•inability to understand directions•sensitivity to touch/sound
ID/Behavioral Cues and Indicators
Impaired Communication
Shortened Attention Span
Poor Sense of Time
Immature Social Relationships
Overly Compliant
Difficulty with Simple Tasks
Poor Understanding of Consequences of
Actions
•Approach in a calm and respectful
manner•Be patient•Use simple language •Ask short open ended questions•Speak slowly and clearly in normal tone
of voice•Allow the individual to set the pace•Give praise and encouragement
ID/Initial Contact
•Is the person exhibiting behavior
characteristic of physical or
developmental disability?•Is the person exhibiting behavior
characteristic of mental illness?•Is the person under the apparent
influence of alcohol or drugs
Recognize cues that could identify possible cause for behavior:
ID/Questioning
•Allow plenty of time for the individual to respond•Be willing to rephrase the questions•Ask for simple and clear description •Ask open ended questions•Avoid questions regarding complex sequences•Avoid questions like:
“Why do you think he did that?”
“You saw him take the purse, didn’t you?”
•Bystanders who may have observed
the person’s behavior over a span of
time•Family members or acquaintances•Other form of information that a
person may carry (e.g., ID cards in
wallet, emergency cards)
Gather additional information from:
ID/Resolution Options
•Detention for evaluation •Cite and release•Referral to support services•Arrest •No action
Cerebral Palsy
•The term cerebral palsy refers to a
large group of chronic conditions
that affect an individual’s body
movements and coordination. •The condition can also affect
speech, hearing, vision,
bowel/bladder control and
eating/swallowing
CP/Indicators
•loss of motor control (awkward gait and poor balance,
impaired coordination of movements, grimacing or drooling
due to poorly controlled facial muscles)
•use of mobility aid such as wheelchair
•limited range of motion
•involuntary jerky movement
•slow and/or slurred speech
Graham Police-Part 1
VIDEO
Autism Spectrum Disorder
ASD is an ongoing I/DD usually evident by
early childhood that affects the ability to
function and interact with others and the
environment. It is more commonly seen in
males than females.
ASD/Indicators
•Difficulty relating to people•Aversion to being touched, especially by a stranger•Sensitivity to noise•May cover their eyes or ears to prevent unpleasant stimulus•May appear to be fascinated by shiny objects•Few social skills•May be non-responsive to questions•May stare or avoid eye contact•Tantrums, self-stimulation, or self mutilation•Eating nonfood items or objects•Inability to respond to command
Graham Police -Part 2.
Second clip starts at 2:41
VIDEO
Buckeye Police -LD37 video
edited to 4 mins 41 sec
VIDEO
Epilepsy
Epilepsy is a brain disorder that
causes people to have recurring
seizures. The seizures happen when
clusters of nerve cells (neurons) in the
brain send out the wrong signals.
Behavioral Indictors: Epilepsy
•Lethargic•Slurred speech •Staggering or impaired gait•Tic-like movements•Rhythmic movements of the head•Purposeless sounds and body movements•Dropping of the head •Lack of response•Eyes rolling upward•Lip smacking, chewing, or swallowing movements•Partial or complete loss of consciousness
Field Contacts With Persons With
Epilepsy
Learning Need #3
Physical Disabilities
Can be the result of any of a
number of illnesses. Two of the
most common are Stroke and
Dementia.
Acquired Neurological Disorder
Signs and Symptoms/Stroke
•Muscular weakness•Facial paralysis •Incontinence •Loss of balance •Labored breathing •No or slurred speech •Loss of basic motor skills
Signs and Symptoms/Dementia
•Memory loss•Verbal repetition•Loss of communication skills •Disorientation of time and
place•Wandering or lost•Indecent exposure
Traumatic Neurological Disorders
Are caused by injury to the brain
or spinal cord due to military
combat, a vehicle accident,
sports injury, fall, act of violence,
or any number of other forms of
trauma.
Example of Traumatic Disorders
•Traumatic Brain Injury: TBI is an
alteration in the brain function or other
evidence of brain pathology, caused
by an external force•This altered state can result in an
impairment of the person’s cognitive
abilities, physical functioning, and/or
emotional functioning
Brett's Story: TBI
VIDEO
List of Mobility Assistance Equipment
and Devices
•Canes•Crutches•Walkers•Braces•Prosthesis•Motorized scooters•Manual or motorized wheelchairs•Service dogs•Personal attendants
Blind or Visual Impairment/Indicators
Deaf and Hard of Hearing/Indicators?
Methods to Communicate
With a Person Who is
Deaf?
Additional Laws Protecting the Rights of
People With Physical Disabilities
People with physical disabilities have
the same right as people without
disabilities to the full and fee use of
street, highway, sidewalks,
walkways, public buildings, public
facilities, and other public spaces.
(Civil Code Section 54)
Additional Laws Protecting Rights of People w/
Physical Disabilities
•Equal access: Entitled to full/equal access
•Rehabilitation Act of 1973: Requires that school districts that receive any
federal funding make programs and activities accessible individuals with
disabilities.
•Failure to comply: Criminal/civil liability
•Blind or visually impaired pedestrians: Are not required to carry a white cane
•Right-of-Way: 21963 VC -Failure to yield to a blind pedestrian (total/partial)
w/ cane/dog -guilty of Misdemeanor
Service animals
According to the ADA
service animals are defined
as dogs that are individually
trained to do work or
perform task for people with
disabilities.
Veteran humiliated over service dog
VIDEO
Learning Need #4
Person with Mental Illness
Mental Illness
Mental illnesses are a medical condition that
affects a person’s thinking, feeling, mood, ability to
relate to others, and disrupts daily functioning.
Persons managing a mental illness can have a
substantially diminished capacity of coping with
the ordinary demands of life.
Mental Disorder:
•Primarily a brain disorder•Creates problems with feeling, thinking, and
perception•Affects a person’s behavior by causing bizarre
and/or inappropriate behavior•Can be short term (acute) or long term (chronic)•Can occur at any time during a person’s life
San Jose State University
Police
VIDEO
Thought Disorders/Mental Illness
A Thought Disorder condition
where the person’s thought process
is disrupted causing that person to
experience delusions,
hallucinations, and/or irrational
fears, of they may exhibit unusual
behavior.
Mood Disorder/Mental Illness
A mood disorder, also referred
to as an affective disorder, is
condition where the person
experiences periodic
disturbances in mood,
concentration, sleep activity,
appetite, or social behavior.
General Behavioral Indictors Associated with Mental
Illness, can include:
•Fearfulness•Inappropriate Behavior•Extreme Rigidity or Inflexibility•Excitability•Impaired Self-care•Hallucinations•Delusions•Disorganized Speech, Thought Patterns, or
Disorientation
Officers should not attempt to diagnose
mental illness. A mental illness is often
difficult for even the trained
professional to define in a given
individual. Become familiar with the
general indicators of mental illness so
that appropriate actions can be taken.
•Isolation•Sadness, inactivity and self depreciation•Feelings of guilt, hopelessness, helpless, or pessimism•Eating disturbances •Fatigue, decreased energy•loss of motivation•Crying spells•Chronic pain•Sleep disturbances•Relentlessness or irritability•Difficulty concentrating or making decisions•Thoughts of death (attempts or threats of suicide)
Clinical depression is the most common of the mood disorders.
Symptoms may include:
Blue in Blue Police
Depression and Stress
VIDEO
Bipolar Disorder/Symptoms
may include:
•When in a depressive cycle: may demonstrate
the same behavior as with clinical depression•Manic cycle may exhibit: boundless energy
and enthusiasm, decreased need to sleep,
rapid loud or disorganized speech, short
temper and argumentative speech, impulsive
and erratic behavior, possible delusional
thoughts, hyper religious or hyper sexual.
PBS Paton Blough
VIDEO
Schizophrenia
•It is a group of related disorders in which a person’s
ability to function is marked by severe distortion of
thought, perception, feelings, and bizarre behavior•Most common of the thought disorders. It most often
develop in young adults aged 16-25 and remains
throughout their lives•Affects the person’s ability to work, relate to others, or
take care of oneself
Schizophrenia/Behaviors include:
•Bizarre delusional thinking•Hallucinations•Incoherent, disconnected thoughts and
speech•expression of irrational fear•Declining self-care•Poor reasoning•Strange and erratic behavior
Learning activity
LD37 VIDEO EDITED TO 4 MINUTES AND 51 SECONDS STARTING AT 9:45
Christopher Remmey
VIDEO
Law Enforcement routinely
encounters persons with mental
illness in a variety of settings. The
causes and impacts of mental
illness vary and are not bound by
race, gender, or socioeconomic
status. Always respond in a
manner that is humane,
compassionate, and supportive.
John Nash Beautiful Mind
VIDEO
Postpartum Depression/Indicators
•Episodes occur in 1/500 to 1/1000 individuals•May impact maternal attitudes toward
infants/children: child abuse, homicidal thinking,
disinterest of the infant)•“Baby Blues” are different from Postpartum: Affects
up to 70% of mothers within 10 days of delivery/no
significant impairment
Postpartum Psychosis/Indicators
Postpartum psychosis is a rare illness
experienced by approximately one in
every 1,000 women after giving birth,
which can substantially diminish the
mother’s capacity for coping with
ordinary like demands.
Psychosis is a severe mental
disorder in which thought and
emotions are so impaired that
contact is lost with external
reality
Psychosis/Indicators
Family Heartbreaking
Tragedy Eyewitness News
VIDEO
Posttraumatic Stress Disorder
Symptoms can include:•Dreams and nightmares about the incident•Flashbacks, hyper-carousel, •Distress caused by reminders of the event,
survivor’s guilt, •Hyper-vigilance, emotional numbing •Exaggerated, startled response (usually to loud
noises)
Post-traumatic Stress Disorder (PTSD) is
an anxiety disorder that can develop after
exposure to a traumatic event or ordeal
The Things We See: PTSD
VIDEO
L37 Video was edited between
1:28 -1:29
The most common personality disorders are:
•Narcissistic (entitlement)•Antissocial (manipulative)•Borderline (abandonment)•Histrionic (theatrical)
Personality traits (enduring patterns of perceiving, relating and thinking) become inflexible and maladaptive
Field Contacts/Persons with
Mental Illness
People affected by mental illness can
be unpredictable and sometimes
violent. Officers should never
compromise or jeopardize their own
safety or the safety of others when
dealing with individuals who display
symptoms of mental illness.
Field Contacts/Person in Crisis
Once the scene is
stabilized and there is no
threat to life then the
officer has a duty to
reasonably
accommodate the
person’s disability, but
not before.
Field Contacts/Persons with
Mental Illness
Not all people with mental illness are
dangerous, while some may
represent danger only under certain
circumstances or conditions. Some
may be capable of going very quickly
from a state of calm to being
extremely agitated.
Athens Georgia Police
VIDEO
Indicators to consider while dealing with a person
experiencing a mental health crisis:
The availability of any weapons
Statements made by the person that suggest that he or
she is prepared to commit a violent or dangerous act.
History
Signs of violence at the scene prior to the officer arriving
Statements made by a credible third party
The amount of self-control/lack of control (signs of rage,
anger, fright, or agitation)
Begging to be left alone
Request Backup: Situations can be
unpredictable
Appropriate tactical actions/person in
crisis:
•Stabilize the Scene •Calm the Situation•Communicate: Acknowledge the person’s feelings,
establish auditory/visional hallucinations, do not
mock the person or belittle their behavior •Do Not Make Threats•Be Truthful
LAPD West Valley -OIS
VIDEO
Crisis Intervention
Crisis by definition is short-term and overwhelming and
involves a disruption of an individual’s normal and stable
state where the usual methods of coping and problem
solving do not work.
Crisis Intervention
Be aware that your uniform, badge, gun, and police car may
frighten the person with mental illness so reassure them
that no harm is intended.
•Recognize that a mentally ill person in crisis may
be overwhelmed by:
•Sensation: Seeing you as a devil in an officers
uniform
•Delusion: Frightening or false beliefs
•Hallucinations: Hearing a voice you want to hurt
them
Crisis Intervention
If you take a LESS authoritative, LESS controlling, LESS
confrontational approach, you actually will have MORE
control.
Crisis Intervention
Allow person to vent energy, maintain safe distance, talk
in low voice, broken record, reassure.
Crisis Intervention
De-escalation Requires
Cooperation
illusion of alternatives
“Would you like to…”
In order to use this, you must understand the subject’s
worldview and be able to pick the choices that fit into
that worldview
Examples of communication with a person in crisis:
GUIDELINES FOR DEALING WITH MENTALLY ILL PEOPLE
Examples of communication with a person in crisis
In order to understand their worldview:
Listen carefully to their use of language to describe the
personal world (abstract ideas or thoughts and feelings)
What do they select from their environment to pay
attention to or ignore
GUIDELINES FOR DEALING WITH MENTALLY ILL PEOPLE
Examples of communication with a person in crisis:
Get the person to say yes or ok to
trivial questions first
Focus on Behavior
Don’t identify their behavior for them
Instead of saying: “you’re hostile” say “what you said
sounded hostile, did I do something to make you mad?”
Examples of communication with a person in crisis:
Do not try to assume intimacy or friendship
when you do not have a relationship with the
person
Don’t say “You’re a nice guy”
That invites the argument “You don’t know me,
I’m not a nice guy”
Examples of communication with a person in crisis:
Will you? vs Can you?
Can indicates that you are questioning their capability
This can make them angry without even knowing why
they are angry
Examples of communication with a person in crisis:
Do not promise or
guarantee anything
You will lose your
credibility when you can’t
deliver
Examples of communication with a person in crisis:
Resolution options/person in crisis:
•Provide Urgent Medical Attention•Arrest of Individual•Referral for Mental Health Services•Report to Child Protective Services:
(Required by law to report conditions
of child abuse to DCFS)•Cite and Release•No Further Action
Learning Need #5
Welfare and Institutions Code
Peace Officers must become familiar with the
application of Welfare and Institutions Code
Section 5150 in order to determine if an
individual is a danger to others, or to himself or
herself, or gravely disabled and to determine
an appropriate response and resolution option.
Lanterman-Petris-Short Act
Frank D. Lanterman Nicholas C. Petris Alan Short
LPS was established in 1968 with the intent to end the
inappropriate, indefinite, and involuntary commitment of
persons with mental health disorders, developmental
disabilities, and chronic alcoholism.
When a person as a result of mental health disorder is a
danger to others, or a danger to himself or herself, or
gravely disabled. A peace officer or other designated
person may upon probable cause take or cause to be
taken the person into custody for a period of up to 72
hours for assessment, evaluation, and crisis
intervention, or placement for evaluation and treatment
in a designated facility
Welfare and Institutions Code
5150
A person that is authorized to
write the hold shall consider
available relevant information
from the person, service
providers, or family members
about the historical course of the
person’s mental disorder.
5150.05
Because deprivation of personal liberty is involved and
officer must clearly articulate the circumstance under
which the person’s condition was brought to the
officer’s attention. Officer must:
•be able to state known facts•that would lead a person of ordinary care and
prudence to believe or to entertain a strong
suspicion •that the person detained•is a danger to others, or self, or is gravely disabled
Danger to Self
Indicators might include, but are not limited to the individual’s:
•words or actions that imply an intent to commit suicide or inflict
bodily harm on self•exhibition of gross neglect for personal safety which could lead
to that person receiving or being at risk of receiving serious
injury •statements or actions implying a specific plan to commit suicide
or inflict harm on self•plans and the means available or within the individual’s ability
to carry out
Danger to Others
Indicators might include, but are not limited to the individual’s:
•words/actions indicating the intent to cause bodily harm to another
person•appearance of being agitated, angry, or explosive •engagement in or intent to engage in acts or behavior of such an
irrational, impulsive or reckless nature as to put others directly in
danger of harm•acts or words regarding an intent to cause harm to another person
being based on or caused by the individual’s mental state
Gravely Disabled:
Indicators might include, but are not limited to the following:
•The person must "presently" be unable to provide and or
utilize food, shelter and clothing due to a mental disorder.•Mere inability to provide for needs is not sufficient nor is
refusal of treatment evidence of grave disability •Regardless of person’s past, the question is whether they
are presently gravely disabled.
Gravely Disabled Minor
A person 17 years old or younger who, as
the result of a mental health disorder, is
unable to utilize the elements of life,
which are essential to health, safety and
development, including food, clothing,
shelter, even though provided to the
minor by others, (WIC 5585.25).
Examples may include but not be limited to:
•surviving safely with the help of responsible family, friends
or others who are both willing and able to help to provide
basic personal needs
•using poor judgement or displaying eccentric behavior does
not necessarily mean a person is incompetent
•chosen lifestyle or lack of funds
Not Gravely Disabled
Deprivation of Personal Liberties
Officers must be aware of the responsibility involved when
they evoke WIC Section 5150. Detention and commitment
can mean the individual: may be deprived of contacts with
with friends and family, may be subject to medical and
psychological examination, and/or the administration of
medications, and can be held against the person’s will for up
to 72 hours. The detention under WIC Section 5150 can not
be based on vague, ambiguous, unspecific, or potentially
dangerous behavior.
Rights of Detained Person
People who are detained under
WIC Section 5150 are entitled to
basic federal and state
constitutional rights. Prior to
transporting, officers must give
the following advisement:
“My name is (Officer A. Foley), I am a
(Police Officer) with (LBPD). You are
not under criminal arrest, but I am
taking you to for an examination by
mental health professionals to (College
Medical Center or any LPS Designated
Facilities). You will be told your rights
by the mental health staff.”
Rights of Detained Person
“You may bring a few personal items
with you which I will have to approve.
Please inform me if you need
assistance turning off any appliance or
water. You can make a phone call
and/or leave a note to tell your friends
and/or family where you have been
taken.”
Section 835(a)
(2)A peace officer shall not use deadly force
against a person based on the danger that
person poses to themselves, if an objectively
reasonable officer would believe the person
does not pose an imminent threat of death or
serious bodily injury to the peace officer or to
another person.
New Senate Bill 392
Whenever a person who had been
detained under Welfare and Institutions
Code Section 5150 is found to own,
have possession of, or have control of
any firearms or deadly weapons,
peace officers will confiscate those
weapons.
8102 WIC
Application for 72-Hour Detention, Evaluation, and Treatment
form (DHCS 1801),
a standard application includes:
•verification that the detainment advisement was given•the name of the designated facility to which the person is
taken•the name and address of the individual who is being detained•factual circumstances and observations constituting probable
cause for the officer to believe that the individual is in fact a
danger to others, self, or is gravely disabled
There is no such thing as a
voluntary 5150 WIC
Confidentiality of medical reports
Officers are responsible for being aware
of state and federal statutes that govern
the release of medical records.
Health Insurance Portability and
Privacy Act
[HIPPA]
News clip-Officer suicide on the
rise
VIDEO