Florida Inmates With Mental Illness PDF

Unit 4 Mentally Ill Inmates and Inmates With Disabilities Lesson 2 Inmates With Mental Illness Lesson Goal You will be able to communicate with and de-escalate situations involving inmates with mental illness. Think About This According to the Florida Department of Corrections, an increasin...

Unit 4 Mentally Ill Inmates and Inmates With Disabilities Lesson 2 Inmates With Mental Illness Lesson Goal You will be able to communicate with and de-escalate situations involving inmates with mental illness. Think About This According to the Florida Department of Corrections, an increasing number of inmates are people with mental illness. Rates of inmates with serious mental illnesses are four to six times higher in jails and three to four times higher in prisons than the general population. More than two-thirds of jail inmates and half of prison inmates also have a substance use disorder. Paying close atten- tion to this lesson can provide the foundation for supervising these inmates with a patient, non- confrontational approach. As defined in s. 394.455, F.S., mental illness is an impairment of the mental or emotional processes that exercise the conscious control of one’s actions, and it can interfere with a person’s ability to perceive or understand reality. You will encounter inmates with mental illnesses during your career. ✅ CO742.1. Know the rights of mentally ill inmates in a correctional setting according to the Florida Statutes According to s. 394.459, F.S., inmates with mental illness have the right to individual dignity and treatment. Procedures, facilities, vehicles, and restraining devices used for criminals do not apply to a person who has a mental illness except for the protection of the person or others. Mood disorders, thought disorders, and personality disorders are categories of mental illness. An inmate can display one or multiple behaviors associated with these disorders. Having an aware- ness of how these disorders appear in inmates and how to respond to these behaviors can make supervising these inmates less challenging. Psychotic Disorders ✅ CO742.2. Know the characteristics of an inmate with a psychotic disorder When an inmate has a psychotic disorder, their thoughts seem disorganized and not logically connected. An inmate may hallucinate—a sensory experience in which someone can smell, taste, or feel something that is not there. An inmate may have delusions—false beliefs firmly held despite obvious proof or evidence to the contrary. A common psychotic or thought disorder is schizophre- 216 / Florida Basic Recruit Training Program (CO): Volume 1 nia, a brain disorder caused by a chemical imbalance that distorts the way a person thinks, acts, expresses emotion, and perceives reality. Psychotic inmates (those hearing voices, for example) are sometimes preoccupied with internal voices, do not hear you, and cannot follow commands. Mood Disorders ✅ CO742.3. Know the characteristics of an inmate with a mood disorder Major depressive disorder (MDD) is one of the most common mood disorders that you may encoun- ter. MDD is different from the brief, situational depressive episodes that most people commonly experience with the loss of a loved one, the loss of a job, or a financial loss. MDD is a clinically diag- nosed mental illness for a person having multiple, major depressive episodes. Symptoms may be severe, can last for several weeks, and do not include periods of persistent high moods (mania). You may notice an inmate is profoundly sad; cries uncontrollably; is unable to concentrate, eat, or sleep; or is suicidal. Bipolar disorder (BD) is another common mood disorder. Formerly known as manic-depressive illness, BD is a clinically diagnosed mental illness with alternating episodes of depression and mania. Symptoms of a manic episode include loud, quick, uninterrupted speech, racing thoughts, fidgeting, and hyperactivity. A person in a manic episode feels charged up, high, or excitable. Usually, people with mania have previously experienced one or more episodes of major depression. Inmates may also have a substance-induced mood disorder from drug and alcohol abuse and can be easily distracted or may have an exaggerated sense of self, powers, and abilities. Inmates with psychotic or mood disorders do not react the same way other inmates do when you give them orders. Anxiety Disorders ✅ CO742.4. Know the characteristics of an inmate with an anxiety disorder The characteristics of an anxiety disorder include excessive nervousness, tension, apprehension, “fight or flight” behavior, excessive fear, or anticipation of looming danger, flashbacks, or ritualis- tic behavior, such as excessive hand washing. Anxiety disorders can range in intensity from mild to debilitating. Some people with anxiety disorders can have panic attacks that are so severe that they mimic a heart attack. You may encounter four main types of anxiety disorders in the correc- tional setting. An inmate who has a panic disorder can experience an extreme panic attack with a racing heartbeat, sweating, tension, and a feeling that something terrible is about to happen. Chest pain or discomfort, sweating, trembling, choking, or a feeling that one is going to die could accompany a panic attack. An inmate who has obsessive compulsive disorder (OCD) has intrusive thoughts and impulses resulting in ritualistic behavior, such as an excessive need to count, excessively wash their hands, or an extreme need to avoid dirt. Chapter 7 Supervising Special Populations / 217  A traumatic event, such as war, natural disaster, sexual or physical assault, or the unex- pected death of a loved one, can cause post-traumatic stress disorder (PTSD). Character- istics of PTSD are lasting thoughts and memories of terror causing emotional numbness. An inmate with PTSD may not have had the traumatic experience but may have witnessed it or been affected by another’s trauma. Phobia is an intense fear of a specific object or situation, such as a fear of heights, spiders, or leaving home. Personality Disorders ✅ CO742.5. Know the characteristics of an inmate with a personality disorder A personality disorder is a deeply ingrained, non-psychotic, inflexible pattern of relating, perceiv- ing, and behaving. It is serious enough to cause distress to the people around an inmate with the disorder. Depending upon the specific disorder, a person may display anxiety, fear, drama, emotion, unpredictable behavior, or impaired function. You may encounter three common personality disor- ders in a correctional facility such as antisocial, narcissistic, and borderline personality disorder. Inmates with these disorders may display some of the following behaviors: Antisocial Narcissistic Borderline Personality Disorder Personality Disorder Personality Disorder a lifelong pattern of an inflated sense of significant emotional violating rules, social norms, importance instability and the rights of others a need for admiration, unawareness of and inability little capacity for empathy, or a desire to be feared to control their behavior guilt, remorse or notorious rapid and intense persistent lying and dramatic mood swings typically exploiting for personal gain emotional behaviors involving angry, erratic, and pleasure difficulties with relationships self-destructive, and disregard for right or wrong a lack of empathy for others impulsive acts toward unnecessary risk-taking aggression when challenged themselves and others homicidal actions impulsive and risky acts inappropriate anger that escalates into physical fights Inmates will often lie about their mental health status; however, you should not try to diagnose whether an inmate is faking a mental health disorder. If you have any doubts about an inmate’s mental status, refer or escort the inmate to the mental health clinic and fully explain your obser- vations to the mental health clinician. 218 / Florida Basic Recruit Training Program (CO): Volume 1 ✅ CO742.6. Know the different ways an inmate with a mental illness may gain access to mental health services Inmates may access mental health services in several ways. An inmate may request an appoint- ment, explain briefly the nature of the problem, and request confidentiality. An inmate may also request mental health services due to an emergency that cannot wait. You may refer an inmate for services, or the Florida Commission on Offender Review or health services staff at a previous institution may refer an inmate. Communication ✅ CO742.7. Know how to communicate with a mentally ill inmate to de-escalate a situation When communicating with inmates with mental illness, be respectful. When someone feels respected and heard, they are more likely to return respect and consider what you have to say. Good communication can help de- escalate a serious negative incident and provide immediate protection and support to the mentally ill inmate and those nearby. If an inmate is experiencing an event, such as a hallucination, be aware that the hallucination or the delusion is their reality, and you will not be able to talk them out of that reality. Effective commu- nication with an inmate experiencing active symptoms of their illness is particularly important because the external environment can so easily overwhelm them. When communicating with an inmate with a mental illness: Solve problems using a plan and in a definite order of actions from beginning to end. Make changes gradually. Work on one thing at a time. Avoid continuous eye contact and touching, if possible. Consider temporarily going along with reasonable requests that are not endangering or beyond reason. This gives an inmate the opportunity to feel somewhat “in control.” Avoid agitating the situation. Keep it simple. Say what you mean clearly, calmly, and positively. Temporarily lower your expectations when an inmate shows symptoms of mental illness. If needed, set limits with them as you would others. For example, “I only have five minutes to talk to you,” or “if you scream, I will not be able to talk to you.” Call for backup if you feel physically threatened or need help de-escalating the situation. Listen to an inmate and try to understand what they are communicating. Find out what reality-based needs you can meet. Chapter 7 Supervising Special Populations / 219 Do not do the following when communicating with an inmate with a mental illness: threaten—this may increase fear or may prompt assaultive behavior. shout—an inmate is not listening; other “voices” are probably interfering. criticize—it will make matters worse; it cannot make things better. bait an inmate into acting out wild threats; the consequences could be tragic. crowd an inmate—for officer safety, provide adequate space, as an inmate may be paranoid. block the doorway—but position yourself for safety. assume an inmate is not smart and will believe anything you tell them—mental illness has nothing to do with intelligence. lie—it will usually destroy any rapport you are trying to establish. pass them on to another officer or staff member—this may save you time in the short run but may come back to haunt you later or cause problems for someone else. Refer them to someone else only if it is an appropriate referral. Mental illness alone does not increase the risk of violent behavior; however, when mental illness combines with other risk factors, such as substance or sexual abuse, it increases the risk of inmate violence. Whether an inmate has a mental illness or not, they do not just snap. There is a progres- sion of behaviors toward violence. Recognize those behavioral warning signs and communicate your concerns to your supervisor or the mental health provider. Warning signs can include sleepless- ness, ritualistic preoccupation with certain activities, suspiciousness, and unpredictable outbursts. ✅ CO742.8. Understand the use of force options that can de-escalate a situation involving a mentally ill inmate During a violent incident involving a mentally ill inmate, avoid using batons, chemical agents, elec- tronic immobilization devices (EIDs), specialty impact munitions, and other authorized non-lethal weapons. Following your agency’s policy, refrain from using these weapons unless attempts to de-escalate and resolve the situation are unsuccessful and it appears reasonably necessary to prevent an inmate from taking control of a unit, taking a hostage, or escaping. Use these types of weapons to stop any assault on staff or other inmates when other interventions are ineffective or pose a risk of injury. In addition, use these weapons to disarm an inmate who has a weapon capable of causing injury to staff when other possible means of disarming an inmate pose a risk of injury to the staff involved. Agency policy may involve having a qualified mental health professional provide crisis intervention and attempt to de-escalate the situation and prevent the use of force. Based on your agency’s policy, a mentally ill inmate may receive a medical examination and treat- ment after they have been subject to an EID or non-lethal weapon. 220 / Florida Basic Recruit Training Program (CO): Volume 1 The Baker Act Also known as the Florida Mental Health Act, the Baker Act provides for emergency services, temporary detention for evaluation, and voluntary or involuntary short-term community inpatient treatment, if necessary. ✅ CO742.9. Know the role of the Baker Act as it relates to inmates with mental illness In a detention setting, you or a health professional may apply the Baker Act at the end of an inmate’s sentence if the inmate displays behavior(s) indicating the need for evaluation. According to s. 394.463, F.S., a law enforcement officer may take an inmate to a receiving facility for involun- tary examination if there is reason to believe the inmate has a mental illness, and because of their mental illness, the inmate is unable to care for themselves, or to protect the inmate from harming themselves or others. Chapter 7 Supervising Special Populations / 221