Force Science News #267:

Simple form helps officers expedite mental illness calls

2014 and 2015 Force Science Certification Course dates and locations can be found at: www.forcescience.org/schedule.html or you can click here.

 

In this issue:

 

I. Simple form helps officers expedite mental illness calls

II. Suspects on a curb: Are you as safe as you may think?

III. Study on stress-related memory damage now in print

IV. Expert feedback on body camera report

 

I. Simple form helps officers expedite mental illness calls

 

A unique mental health assessment form that can help officers better communicate with medical personnel and may contribute to reduced wait times in hospital emergency rooms is becoming more widely used now after successful pilot studies.

 

The simple, one-page checklist of various "mental state indicators and behaviors" is designed to give street officers and hospital staffs a "common, descriptive but efficient language" to aid in determining whether a subject who appears to be mentally ill requires admission to a treatment facility in the interest of safety.

 

In the blunt explanation of one officer, "It helps me put into the right words the bizarre shit I'm looking at."

 

The Brief Mental Health Screener (BMHS) was developed primarily by Ron Hoffman, PhD, a former Toronto constable who now serves as coordinator of mental health training at the Ontario (Canada) Police College.

 

Hoffman, who previously had a leading role in creating a template that helps Canadian officers articulate use-of-force decisions, designed the new screener with assistance from his academic advisor, Dr. John Hirdes, and other researchers as a project for his advanced degree in health studies.

 

We first described Hoffman's project in Force Science News #191 (sent 11/18/11) when the checklist was being field-tested in a pilot study by two agencies in Ontario. Now it has been adopted throughout the jurisdiction of the Ontario Provincial Police (OPP), other agencies are also in line to begin using it, and it is being presented to medical conferences worldwide. Recently, for example, it received a very positive response from 10,000 delegates, mostly psychiatrists, attending the World Psychiatric Congress in Madrid, Spain.

 

SEEKING COMMONALITY. The BMHS grew from Hoffman's realization that there is often a significant disconnect between LEOs and medical personnel when police bring subjects who seem mentally disturbed to the ER.

 

"Doctors and nurses use a different language and approach the situation from a different perspective than cops," Hoffman says. "They are looking for specific cues that can give them quick insights into a subject's mental state, but officers may not articulate what they've observed in the way that is most meaningful to them for making reasonable decisions.

 

"This tends to slow down the evaluation process, and officers end up spending a lot of time--expensive time--just waiting around for decisions to be made."

 

In search of commonalities that might prove helpful in expediting things, Hoffman pored through a data base of more than 41,000 files of persons who had been admitted to psychiatric facilities for observation or treatment in Ontario.

 

From this he pinpointed "core elements of clinical significance"--statistically relevant behavioral indicators of potential danger to self or others that police might see during their interventions and that also appeared to be related to the admission decisions made by health professionals.

 

He then reduced the most common cues to terminology and checkpoints that both "capture the often bizarre-type behavior" officers encounter and are meaningfully descriptive to medical personnel. The checklist was fine-tuned across "many meetings" with input from both the health services and law enforcement communities, Hoffman says.

 

KEY COMPONENTS. The resulting evidence-based BMHS calls for officers to enter their observations regarding a suspected mentally disturbed person in two key sections: 1) "Indicators of disordered thought" and 2) "Indicators of risk of harm."

 

In the "disordered thought" section, officers are asked to check off:

 

• whether the person is subject to such disturbances as command hallucinations, hyper-arousal, pressured speech, disruptive behavior, or half a dozen other "mental state indicators"

 

• the extent to which the person seems aware of his or her mental health problem

 

• the degree to which the person's skills for making decisions regarding the tasks of daily life, such as eating or getting dressed, seems to be impaired.

 

In the "risk" section, officers note such information as:

 

• the person's use or carrying of weapons

 

• his or her ideation or use of violence toward others or self

 

• conditions of the person's home environment

 

• compliance with taking prescribed meds.

 

The completed form is then sent ahead electronically or brought by the officer with the prospective patient when they arrive at the ER. The single-page summary gives the hospital staff a leg up in evaluating and processing the individual, Hoffman says.

 

ENTHUSIASTIC ACCEPTANCE. During the pilot studies and since the BMHS went province-wide last spring, both police and health staff alike have embraced it, Hoffman reports.

 

"While officers can be averse to additional paperwork, the fact that this screener is brief made buy-in easier," says Insp. R. Scott Smith, a detachment commander with the OPP. "By using this standardized instrument, officers are able to clearly and concisely articulate their grounds for apprehending an individual and bringing them to a hospital for assessment."

 

Also, he notes, the form has been helpful as "part of a broader mental health strategy," allowing his agency "to track all calls for service where mental disorder is a factor. We have been able to observe changes in the behavior of those we have frequent contact with, and it has helped us mobilize community mental health services to engage with vulnerable individuals before a crisis situation develops."

 

Barb Pizzingrilli, a mental health program manager with Ontario's Niagara Health System, praises the BMHS as well. The fact that psychiatric emergency service staff "are now speaking a common language" with officers has "facilitated safe, risk-focused transfers" of mental patients to appropriate care facilities, she says.

 

In addition, she says, use of the new form as part of a "larger protocol" has helped reduce the average police wait time in one emergency department she's familiar with from "3.2 hours to one hour," while strengthening the "collegiality and collaborative dynamic" between medical personnel and LEOs.

 

YOURS FOR THE ASKING. The BMHS is a copyrighted document, but Hoffman wants it used as broadly as possible. If you would like a copy for your agency, along with permission to reproduce it for your personnel and an explanation of the related training necessary, contact him for the protocol at: Ron.Hoffman@ontario.ca

 

Our thanks to Chris Lawrence, a member of the Force Science Certification Course instructor team, for helping to facilitate this report.

 

 

II. Suspects on a curb: Are you as safe as you may think?

 

As a street cop and as a trainer, Duane Wolfe has seen and used the tactic many times: officers positioning an unrestrained subject on a curb with his legs configured to delay him in launching a physical attack.

 

Some have the suspect extend his legs straight out. Others order his ankles crossed. Still others prefer the legs pulled back and crossed.

 

But how much reaction time, Wolfe wondered, does this tactic actually buy you? And is there one position that is superior to others?

 

A graduate of the certification course in Force Science Analysis and a law enforcement instructor at Alexandria (MN) Technical and Community College, Wolfe recently decided to put these questions to a test--with some unexpected results.

 

ATTACK SIMULATION. In a street-scene setting inside the college's "Tactical Warehouse," he tested 42 LE program volunteers, ranging in age from 19 to 25 and all but one of them male. Their footwear for the experiments ranged from athletic shoes to duty boots to cowboy boots.

 

One at a time, they sat unhandcuffed on a six-inch curb and, at the sound of an audible tone, moved as fast as they could to slap a timer positioned on a table five feet away. Each was evaluated three times from the three positions commonly used on the street: legs straight out, legs out with ankles crossed, and legs crossed "yoga-style" with heels tucked back against the curb.

 

SPEEDS. Here are the average times (in seconds) required to reach the timer--i.e., an officer at that location--for each of the positions:

 

Position: Straight legs

Average Time: 1.34

Fastest Time: 1.14

Slowest Time:1.97

 

Position: Crossed ankles

Average Time: 1.35

Fastest Time: 1.02

Slowest Time: 2.16

 

Position: Crossed legs

Average Time: 1.30

Fastest Time: 0.90

Slowest Time: 1.77

 

Wolfe had expected that on average the crossed-ankle position would cause the "suspects" the greatest delay in reaching the point of attack. And it did. But the difference, he told Force Science News, proved to be negligible.

 

The average suspect moving from that posture was only 5/100 if a second slower than from the least-inhibiting position (cross-legged). "Insignificant...just an eye blink," Wolfe says.

 

Moreover, he explains, these times include the time required for the suspects to hear the tonal signal, mentally process it, and begin to move. If a suspect in the real world was initiating an attack at a time of his own choosing, rather than reacting to a beep, he could probably shave from 0.14 to 0.16 second off his time, Wolfe estimates.

 

"If the officer is distracted when an attack is launched, a suspect who starts from any of these positions will very likely be able to reach his target before the officer can effectively react to stop him or to escape," Wolfe says.

 

BIGGEST SURPRISE. The "biggest surprise," however, was the manner in which the test subjects moved. "I assumed everyone would rise to their feet, at least in a crouch, then go for the timer pad," Wolfe explains. But many just "threw their upper body forward, tucked their feet in, and lunged, with one or both knees staying on the ground or close to it. Those who stayed on both knees generally had the fastest times."

 

Especially with a suspect who's knowledgeable in mixed martial arts, "coming in low like that, taking out an officer's legs between knee and groin level, is very difficult to defend against," Wolfe says.

 

LESSONS LEARNED. After watching more than 370 attack attempts during the study, Wolfe offers these observations for making curb seating safer on the street:

 

• "The test subjects always placed one or both hands down on the curb as a means of using their upper body to push forward. So stay alert for placement of the hands flat on the curb close to the hips as a possible pre-attack cue."

 

• "What matters is not what seating position is used but the distance between you and the suspect. Your reactionary gap needs to be figured from where his feet are, not from his upper body." Wolfe recommends keeping a space of five to seven feet or more from a seated subject's feet, and standing at an angle to him rather than straight-on to further add time to his effort to reach you. "If you have to approach a seated suspect, try to do so from the rear."

 

• "The times established by the study are averages," Wolfe reminds. "Some people are faster, some are slower. On the street, you never know where your suspect will be on the scale. And you may not know whether your reaction time will be better than the average officer's--or worse."

 

Wolfe can be reached at: DuaneW@alextech.edu

 

 

III. Study on stress-related memory damage now in print

 

Findings from a first-of-its-kind study by the Force Science Institute, confirming the difficulty officers have in recalling certain details after a shooting, have now been published in full in the international journal Police Practice and Research. We earlier provided a summary of the study's highlights in Force Science News #250 [2/26/14]. Click here to read it.

 

The study, headed by Dr. Bill Lewinski, FSI's executive director, focused on officers' general inability to accurately reconstruct their path of travel after they had fled from a sudden gun assault as an example of how memory is often adversely affected by life-threatening stress.

 

In the researchers' experiments, officers tended to be significantly inaccurate in recalling how they ran from the kill zone on a traffic stop gone bad, misestimating their arc of travel and the distance they covered--details that could be important to their credibility under certain circumstances, Lewinski notes.

 

The report, titled "Police officers' actual vs. recalled path of travel in response to a threatening traffic stop scenario," can be accessed free of charge by clicking here to read it or visit: www.forcescience.org/pathoftravel.pdf

 

 

IV. Expert feedback on body camera report

 

In Force Science News #265 [9/23/14], we explained 10 limitations on body camera evidence that officers and force reviewers should be aware of in controversial use-of-force incidents. Visit: http://www.forcescience.org/bodycams.pdf for a PRINTER FRIENDLY VERSION.

 

Among the responses we have received are these comments:

 

NATO trainer cites auditory, visual alterations cameras miss

I train most of NATO's Press Affairs Officers at the NATO School in Oberammergau, Germany. Congratulations on your very compact, very interesting article about body cams. I don't think you can bring the core points better, briefer, or clearer.

 

The only bullet-point I would add concerns the reaction under high noise exposure. Several studies from the US military show some odd effects, from a "slow-motion experience" while fighting or, in combination with high stress, a deafening effect: the brain fades out any sound to provide more focusing capability.

 

Additionally, as you mention, a body camera also cannot provide the "real image" an officer sees because of the human brain's focus capacity under high stress. Vision narrows to a tunnel view, with the rest of the picture seen as if under foggy conditions.

 

This is not how an audience in court experiences video footage. They comfortably hear and see the whole scene--and time and again, if they want.

 

Col. Gerhard Krejcirik

Federal Ministry of Defence

Vienna, Austria

 

EDITOR'S NOTE: A webpage devoted exclusively to information on body cameras has been established by Americans for Effective Law Enforcement (AELE) at: http://www.aele.org/bwc-info.html

 

Postings include links to model/specimen policies, reports/studies, legislation, litigation, training documents, scholarly journal articles, and other items of interest and use to officers, trainers, administrators, police attorneys, force reviewers, and other professionals interested in this rapidly proliferating technology. Access is free and content will be updated periodically.

 

Through this page, for example, you can link to the recent 77-page report from the Police Executive Research Forum, titled "Implementing a Body-Worn Camera Program: Recommendations and Lessons Learned." This document covers a multitude of police considerations and practical matters related to equipping officers with cameras.

 

 

 

 

 

 

 

 

 

 

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